Comparing oil based ointment versus standard practice for the treatment of moderate burns in Greece: a trial based cost effectiveness evaluation

Abstract

Background: The local treatment of burn wounds has long been a subject of debate. The objective of this study was to compare the cost and the effectiveness of Moist Exposed Burn Ointment -MEBO versus a combination of povidone iodine plus bepanthenol cream for partial thickness burns.

Methods: The study was carried out in the Burn Center of a state hospital in Athens, Greece. 211 patients needing conservative therapy were prospectively selected according to the depth of the burn wound. The treatment was allocated according to the Stratified Randomization Design. The outcomes measured were mean cost of in-hospital stay, rate of complications, time of 50% wound healing, pain scores, in hospital stay diminution. We have adopted a societal perspective.

Results: In the total groups MEBO presented lower cost, (although not significantly different: p = 0.10) and better effectiveness. The data suggest that MEBO is the dominant therapy for superficial partial burn wound with significantly lower costs and significantly higher effectiveness due to a lesser time of recovery and consequently lower time of hospitalization and follow-up. MEBO presented similar percentages of complications with the comparator, lower pain levels and smaller time of no healthy appearance of the burn limits for superficial partial thickness burns.

Conclusions: The data suggested that topical application of MEBO may be considered for further investigation as a potential first-line treatment modality for superficial partial thickness burns.

Trial registration: The trial has been registered on the International Standard Randomised Controlled Trial Number Register (ISRCTN) and given the registration number ISRCTN74058791.

Figure 1

Participant flow through the trial.

Figure 2

Q-Q plots of costs and effectiveness for MEBO group and standard therapy group.

Figure 3

Scatter plots of Incremental costs and effectiveness for total groups, groups with deep partial thickness burs and groups with superficial partial thickness burns.

Figure 4

Cost effectiveness acceptability curve MEBO vs. standard therapy (groups with deep partial thickness burns).

Figure 5

Median daily pain (morning and evening) for total groups, groups with deep partial thickness burs and groups with superficial partial thickness burns.

Figure 6

Distribution of total groups by complication appearance.

Figure 7

Time of no healthy appearance of burn limits (total groups).

Figure 8

Cost effectiveness acceptability curves for deep partial thickness burns (discount rates: 0%,3%, 5%).