Effective harm healing and cost co...

Effective harm healing and cost considerations dictate the dressing choice in the treatment of compressing ulcers. Graumlich and colleagues performed a close attention to compare hydrocolloid dressings with collagen in the healing of stage II and III influence ulcers. Hydrocolloid is a moist, vapor-permeable, occlusive dressing used in damage healing. Collagen, extracted from bovine skin, enhances injury healing through a variety of probable mechanisms, in the same state [i]or[/i] condition as angiogenesis, epithelialization, and granulation.

The investigators listed nursing home patients with stage II to III influence ulcers in a single-blind, randomized trial, in which participants received collagen or hydrocolloid dressings, continuing treatment for eight weeks. The definition of undivided healing was 100 percent epithelial coverage of the research ulcer, with the proportion of completely healed pustules serving as the primary fall of the curtain point. Blinded observers used validated, standardized techniques to record gathering length, width, and appearance.

The inquiry population included 65 patients with a median age of 831 years. The treatment form into groupss were similar in demographic and clinical characteristics. integral healing rates were the same after eight weeks. For collagen patients, the mean healing time was five weeks, and for hydrocolloid patients, the mean healing time was six weeks. After multivariate logistic regression analysis, merely ulcer depth remained a significant predictor of consummate healing within eight weeks. Diabetes mellitus was not originate to be associated with healing consequence (P = .858) in a place hoc analysis. A cost analysis showed that the average preciousness per patient with stage II or III sore s was $222.36 for hydrocolloid treatment and $62756 for collagen treatment.

There was a nonsignificant inclination favoring collagen for healing sore s deeper than 2 mm at baseline. Collagen treatment was more expensive and required more nursing interventions for week. The number needed to treat with collagen is 70 patients for up to eight weeks before united healing event will occur in patients who would otherwise receive hydrocolloid treatment.

The authors bring to an end that no differences could be descryed between collagen and hydrocolloid treatment of press ulcers in treating stage II and III sore s Because depth appeared to be a predictor of healing, the authors propose that further trials should compare efficacy of these agents in reaching far down stage III ulcers.

Caroline Wellbery, MD

Graumlich JF et al. Healing influence ulcers with collagen or hydrocolloid: a randomized, controll trial. J Am Geriatr Soc February 2003;51:147-54

COPYRIGHT 2003 American Academy of Family Physicians

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