Skin Tears - Innovation and Cost Savings using a Silicone Contact Layer

Escalating fiscal challenges require extraordinary reassessment and assimilation of resources.  Home care must leverage costly resources, i.e. the clinical nurse, to achieve efficiency and excellence in clinical outcomes for patients.   We sought to establish and execute a new standard of care for our agency statewide as well as implement an innovative approach to decrease our costs for advanced wound care products. 

Skin tears are highly exudative and physicians routinely order daily dressing changes consisting of a non-adherent gauze layer, covered with absorbent gauze sponges then held in place with rolled gauze.  Typically patients required 15 to 21 days of daily care.  An algorithm for skin tear care was developed and staff statewide attended a mandatory inservice. At the end of the inservice staff were given samples of the silicone non-contact layer.   Concomitantly, since the agency is associated with a large hospital system, negotiations were pursued for a reduction of cost for access for silicone products under the larger contract umbrella.  The overall cost savings were substantial.  The agency reduced its supply costs by 35% for the silicone advanced wound care products and in six months a savings of $65,000 was calculated related to cost of providing care.  

This endeavor yielded several significant observations that correlate to opportunities.  First, this experience substantiates findings in the literature which purport skin tear injuries heal faster using silicone dressings.  Secondly, implementation of a functional algorithm for skin tears, can decrease nursing visits and consequently a greater number of patients can be served.   Lastly, it demonstrates that systematic negotiations with distributors can prove to be a successful strategy in overcoming contractual barriers to decrease costs for advanced wound care products.