Chronic leg ulcers: cost evaluation of two treatment strategies

We sought to determine the cost factors essential in the treatment of chron ic wounds, and whether two different strategies of wound treatment (Vaselin e gauze dressings versus hydrocolloid dressings) show any differences in th eir directs costs and effects nn quality Of life (QoL). Of 25 patients (age d 61.4+/-12.3 years) with ulcus cruris venosum prospectively investigated o ver 6 months with monthly follow-ups, 11 were treated with Vaseline gauze a nd daily dressing changes, and 14 were treated with hydrocolloid dressings changed every 2-4 days. End-points of the economic evaluations were the red uction in ulcer diameter, the direct costs, and the QoL, Total weekly costs of treatment per patient were DM 235 in the gauze group and DM 176 in the hydrocolloid group. The most important factor differentiating between the g roups was the staff costs, which were DM 151 vs DM 80, respectively. In the treatment period of 6 months, the median healing times were 15.6 weeks (ga uze) and 14.3 weeks (hydrocolloid) which resulted in direct costs of DM 366 1 and DM 2522, The results of the cost analysis for Vaseline gauze and hydr ocolloid dressings, respectively, were as follows: (1) costs per centimetre reduction in ulcer diameter: DM 482 and 300; (2) costs for 10% pain reduct ion: DM 538 and 359; (3) costs for 10% improvement in QoL: DM 1046 and 672. The costs for staff are therefore crucial in the treatment of chronic woun ds. Cost-benefit and cost-utility analysis showed better results for hydroc olloid dressings than for Vaseline gauze dressings.