Comparison of costs and healing rates of two forms of compression in treating venous ulcers

The objective of this study was to compare healing rates and costs of treat ing venous ulcers with traditional Unna boots (UB) or a CircAid Thera-Boot (TB). A multicenter, prospective, randomized parallel-group study was perfo rmed in three university medical center vascular surgery clinics and three private medical offices. Patients presented with unilateral venous leg ulce rs 5 cm or less in diameter. Patients with severe arterial, metabolic, or n europathic diseases, and those who would not be expected to heal with conse rvative treatment, were excluded. Conservative treatment of the leg ulcer c onsisted of a nonadherent topical dressing and compression with either a tr aditional Unna's boot or a Thera-Boot. The main outcome measures were the f ollowing: time to healing, rate of area decrease, rate of percent area decr ease, linear healing rate, costs of labor, materials, and overhead. Of 38 e nrolled patients seven were withdrawn (five UB, two TB), Three patients wer e still in treatment when the study was stopped. Eleven UB patients and 17 TB patients completed the study. Healing rates were for UB and TB patients (mean +/- sd) were, respectively: time to healing (weeks) 9.69 +/- 3.28, 7. 98 +/- 4.41 (p = 0.41), area healing rate (cm(2)/day) 0.0239 +/- 0.0534, 0. 0433 +/- 0.0910 (p = 0.27), % area healing rate (%/day) 1.0493 +/- 1.5583, 2.0357 +/- 1.9520 (p = 0.56), and linear healing rate (cm/day), 0.0060 +/- 0.0092, 0.0109 +/- 0.0125 (p = 0.27). Costs for UB and TB (dollars to compl etion) were, respectively: clinician labor 331.37 +/- 255.75, 201.91 +/- 13 1.17 (p = 0.09), materials 160.86 +/- 96.86, 122.79 +/- 27.59 (p = 0.14), o verhead (number of visits) 11.70 +/- 6.40, 6.71 +/- 3.77 (p = 0.02), and to tal costs 901.73 +/- 576.45, 559.41 +/- 290.75 (p = 0.05). Treatment of venous ulcers with CircAid Thera-Boots is significantly less c ostly than treatment with traditional Unna's boots. Trends toward faster he aling were noted.