Pressure ulcer management in home health care: efficacy and cost effectiveness of moisture vapor permeable dressing

Abstract

This prospective randomized study was conducted in the home care setting to compare healing rates and costs of two different dressings for pressure ulcers: the gauze and tape dressing and the transparent moisture vapor permeable dressing (MVP). Demographic variables, healing rates, and cost of treatment were statistically analyzed for 77 pressure ulcers (48 patients). Each wound was randomly assigned to either a gauze dressing or a MVP dressing. Initial ulcer grade (Shea criteria) and measurements were determined at the start of treatment and weekly for an eight-week period. Photographs of the wound were taken at the beginning and end of treatment. The same protocol for irrigating the wound and relieving pressure was followed for both dressing groups. The median improvement for the grade II group was 100% for the MVP (n = 22) and 52% for gauze (n = 12), p less than 0.05 (Wilcoxon rank sum test). The healing rates for grade III ulcers were not significantly different in the two dressing groups. The mean (eight-week) labor and supply cost per ulcer using the MVP was $845, while that for gauze treatments was $1359, p less than 0.05 (Wilcoxon rank sum test). The cost difference for grade III ulcers was not significant in the two dressing groups. The MVP improved the healing rate and was more cost effective for grade II ulcers. Both gauze and MVP dressings proved effective for the treatment of grade III ulcers.