AORN Journal
Volume 77, Issue 5 , Pages 984-1004 , May 2003

The Cost and Efficacy of Two Wound Treatments

  • Virginia A. Capasso, APRN

      Affiliations

    • Virginia A. Capasso, APRN, PhD, is a clinical nurse specialist, vascular nursing and MGH Vascular Home Care Program, and codirector, MGH Wound Care Center, Massachusetts General Hospital, Boston.
  • ,
  • Barbara Hazard Munro, RN

      Affiliations

    • Barbara Hazard Munro, RN, PhD, FAAN, is dean and professor, Connell School of Nursing, Boston College, Chestnut Hill, Mass.

NOTES 

  1. Nicoloff AD , et al.   “Patient recovery after infrainguinal bypass grafting for limb salvage,” . Journal of Vascular Surgery . February 1998;27:256–263
  2. Prospective Payment Assessment Commission . Medicare and the American Health Care System: Report to Congress, June, 1996 . Washington, DC: Prospective Payment Assessment Commission; 1996;
  3. Pieper B , et al.   “Wound prevalence, types, and treatments in home care,” . Advances in Wound Care . April 1999;12:117–126
  4. Ovington L , Pierce B . “Wound dressings: Form, function, feasibility, and facts,” . In:  Krasner D , et al. editor. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals . third ed. Wayne, Pa: HMP Communications; 2001;p. 311–319
  5. Agren MS . “An amorphous hydrogel enhances epithelialisation of wounds,” . Acta Dermato-Venereologica . March 1998;78:119–122 “Focus on amorphous hydro-gels. A wound dressing for fluid absorption or fluid donation?” Wound Care Product Review 1 (Spring 1998) 1; P Sprung, Z Hou, D A Ladin, “Hydrogels and hydrocol-loids: An objective product comparison,” Ostomy/Wound Management 44 (January 1998) 36–46.
  6. Thomas DR , et al.   “Acemannan hydrogel dressing versus saline dressing for pressure ulcers: A randomized, controlled trial,” . Advances in Wound Care . October 1998;11:273–276
  7. Charlson ME , et al.   “Assessing illness severity: Does clinical judgement work?” . Journal of Chronic Disease . June 1986;39:439–452
  8. Wysocki AB . “Evaluating and managing open skin wounds: Colonization versus infection,” . AACN Clinical Issues . August 2002;13:382–397
  9. Suh DY , Hunt TK . “Time line of wound healing,” . Clinics in Podiatric Medicine and Surgery . January 1998;15:1–9
  10. Ibid.
  11. Field FK , Kerstein MD . “Overview of wound healing in a moist environment,” . The American Journal of Surgery . January 1994;167:2S–6S
  12. Winter GD . “Epidermal regeneration studied in the domestic pig,” . In:  Hunt TK ,  Dunphy JE editor. Fundamentals of Wound Management . New York: Appleton-Century Crofts; 1979;
  13. Waldrop J , Doughty D . “Wound healing physiology,” . In:  Bryant R editors. Acute and Chronic Wounds: Nursing Management . second ed. St Louis: Mosby-Year Book, Inc; 2000;
  14. Field, Kerstein, “Overview of wound healing in a moist environment,” 2S–6S.
  15. Ibid.
  16. Bergstrom N , et al.   Treatment of Pressure Ulcers. Treatment of Pressure Ulcer Guideline Panel . Rockville, Md: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1994;
  17. Ibid.
  18. Steed DL . “Diabetic wounds: Assessment, classification, and management,” . In:  Krasner DL , et al. editor. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals . third ed. Wayne, Pa: HMP Communications; 2001;p. 575–581
  19. Bergstrom et al, Treatment of Pressure Ulcers. Treatment of Pressure Ulcer Guideline Panel.
  20. Rodeheaver G , et al.   “Wound healing and wound management: Focus on debridement. An interdisciplinary round table, September 18, 1992, Jackson Hole, WY,” . Advances in Wound Care . January 1994;7:22–36
  21. Ovington LG . “The well-dressed wound: An overview of dressing types,” . Wounds . January/February 1998;10(A suppl):1A–11A
  22. Agren  . “An amorphous hydrogel enhances epithelialisation of wounds,” 119–122; S Bale et al, “A comparison of two amorphous hydrogels in the debridement of pressure sores,” . Journal of Wound Care . February 1998;7:65–68 F Lobasso, T J Stephens, “Use of a reconstituted human skin model for predicting the inflammation potential of wound care products,” Journal of Toxicology—Cutaneous and Ocular Toxicology 12 no 4 (1993) 363–370; Thomas et al, “Acemannan hydrogel dressing versus saline dressing for pressure ulcers: A randomized, controlled trial,” 273–276; S Thomas, P Hay, “Fluid handling properties of hydrogel dressings,” Ostomy/Wound Management 41 (April 1995) 54–59; Sprung, Hou, Ladin, “Hydrogels and hydrocolloids: An objective product comparison,” 36–46.
  23. Thomas et al, “Acemannan hydrogel dressing versus saline dressing for pressure ulcers: A randomized, controlled trial,” 273–276.
  24. Bale et al, “A comparison of two amorphous hydrogels in the debridement of pressure sores,” 65–68.
  25. Thomas et al, “Acemannan hydrogel dressing versus saline dressing for pressure ulcers: A randomized, controlled trial,” 273–276.
  26. Lobasso, Stephens, “Use of a reconstituted human skin model for predicting the inflammation potential of wound care products,” 363–370.
  27. Thomas et al, “Acemannan hydrogel dressing versus saline dressing for pressure ulcers: A randomized, controlled trial,” 273–276.
  28. Brooten D . “Methodological issues linking costs and outcome,” . Medical Care . November 1997;35(11 suppl):NS87–NS95
  29. Mulder DG . “Cost-effective managed care: Gel versus wet-to-dry for debridement,” . Ostomy/Wound Management . March 1995;41:68–74
  30. Maxwell SE , Delaney HD . Designing Experiments and Analyzing Data: A Model Comparison Perspective . Mahwah, NJ: Lawrence-Erlbaum Associates; 1990;
  31. Charlson ME . “A new method of classifying prognostic comorbidity in longitudinal studies: development and validation,” . Journal of Chronic Diseases . 1987;40(5):373–383
  32. Kaplan MH , Feinstein AR . “The importance of classifying initial co-morbidity in evaluating the outcome of diabetes mellitus,” . Journal of Chronic Diseases . September 1974;27:387–404
  33. Bates-Jensen BM , Vredevoe DL , Brecht ML . “Validity and reliability of the pressure sore status tool,” . Decubitus . November 1992;5:20–28
  34. Bates-Jensen BM . “The Pressure Sore Status Tool: A few thousand assessments later,” . Advances in Wound Care . September 1997;10:65–73
  35. Ibid.
  36. Ibid.
  37. Naylor MD , et al.   “Comprehensive discharge planning and home follow-up of hospitalized elders; A randomized clinical trial,” . JAMA . February 1999;281:613–620 Brooten, “Methodological issues linking costs and outcome,” NS87–NS95; M D Naylor, “Comprehensive discharge planning for the elderly,” Research in Nursing and Health 13 (October 1990) 327–347
  38. Thomas et al, “Acemannan hydrogel dressing versus saline dressing for pressure ulcers: A randomized, controlled trial,” 273–276.
  39. Bale et al, “A comparison of two amorphous hydrogels in the debridement of pressure sores,” 65–68; Mulder, “Cost-effective managed care: Gel versus wet-to-dry for debridement,” 68–74.
  40. Carr RD , Lalagos DE . “Clinical evaluation of a polymeric membrane dressing in the treatment of pressure ulcers,” . Decubitus . August 1990;3:38–42 B A Ferrell, D Osterweil, P Christenson, “A randomized trial of low-air-loss beds for treatment of pressure ulcers,” JAMA 269 (January 1993) 494–497; M Itoh et al, “Accelerated wound healing of pressure ulcers by pulsed high peak power electromagnetic energy (Diapulse),” Decubitus 4 (February 1991) 24–34; C Honde, C Derks, D Tudor, “Local treatment of pressure sores in the elderly. Amino acid copolymer membrane versus hydro-colloid dressing,” Journal of American Geriatric Society 42 (November 1994) 1180–1183; J D Kramer, M Kearney, “Patient, wound, and treatment characteristics associated with healing in pressure ulcers,” Advances in Skin and Wound Care 13 (January/February 2000) 17–24.
  41. Kalani M , et al.   “Transcut-aneous oxygen tension and toe blood pressure as predictors for outcome of diabetic foot ulcers,” . Diabetes Care . January 1999;22:147–151
  42. Capasso VA . “The theory is the practice: An exemplar,” . Clinical Nurse Specialist . November 1998;12:226–229 S K Chase, M Melloni, A Savage, “A forever healing: The lived experience of venous ulcer disease,” Journal of Vascular Nursing 15 (June 1997) 73–78; S K Chase et al, “Living with chronic venous leg ulcers: A descriptive study of knowledge and functional health status,” Journal of Community Health Nursing 17 (Spring 2000) 1–13; D Krasner, “Painful venous ulcers: Themes and stories about living with the pain and suffering,” Journal of Wound, Ostomy, and Continence Nursing 25 (May 1998) 158–168; D Krasner, “Using a gentler hand: Reflections on patients with pressure ulcers who experience pain,” Ostomy/Wound Management 42 (April 1996) 20–26; “Consensus Statement on Emerging Nursing Knowledge: A Value-based Position Paper Linking Nursing Knowledge and Practice Outcomes: USA Nursing Knowledge Consensus Conference, 1998,” Boston College, http://www.bc.edu/bc_org/avp/son/theorist/consensus2.html (accessed 13 March 2003).
  43. Mulder, “Cost-effective managed care: Gel versus wet-to-dry for debridement,” 68–74.
  44. “IPS/PPS information,” Homecare Online . http://www.nahc.org/NAHC/LegReg/IPS_PPS/ipspps.html (accessed 13 March 2003)
  45. Reiber GE , Lipsky B , Gibbons GW . “The burden of diabetic foot ulcers,” . The American Journal of Surgery . August 1998;176(2A suppl):5S–10S J A Dormandy, R B Rutherford, “Management of peripheral arterial disease (PAD). TASC Working Group. TransAtlantic Inter-Society Consensus (TASC),” Journal of Vascular Surgery 31 (1 part 2) (January 2000) S1–S296.

 Editor's note: This study was supported by a research associate grant from the AORN Foundation. Virginia A. Capasso, APRN, PhD, gratefully acknowledges the support of members of her doctoral dissertation committee and her research assistant in the design and implementation of this study: Sally Rankin, RN, PhD, FAAN, former associate professor, Connell School of Nursing, Boston College, Chestnut Hill, Mass; Susan Chase, RN, EdD, former associate professor, Connell School of Nursing, Boston College, Chestnut Hill, Mass; and Melissa Comeou, RN, BSN, former staff nurse, vascular nursing, Massachusetts General Hospital, Boston.

PII: S0001-2092(06)60713-8

doi: 10.1016/S0001-2092(06)60713-8

AORN Journal
Volume 77, Issue 5 , Pages 984-1004 , May 2003