Use of a Superabsorbent Dressing to Control Copious Drainage in Patients with Venous Ulcerations

 

Clinical Problem: Cost- effective wound management must take into account the cost of dressings, time to healing and provider visits. This is especially true in the home health arena as well as patients being served by providers under a capitated reimbursement or managed care system.  Uncontrolled exudate squanders resources, add to increased morbidity, and impact wound healing.^{1, 2} Patients report failure of absorbent wound dressings and resort to products not formulated for wound care, such as baby diapers³ with or without the usual absorbent dressings.

Method: A case series of six patients with copious amounts of drainage and history of periwound adhesive related skin injury requiring three times a day using silicone based foam dressings*,**  were placed on a new superabsorbent non-adhesive dressing*** for one month. Patients continued with their compression requirements and lymphedema therapy treatments. Evaluation endpoints included the number of dressing changes, pain, and periwound skin condition.

Results: All patients had a reduction in wound dressing changes to a maximum of once daily. (Mean 1.9 days; range 1-3 days) Periwound maceration was improved in two patients and resolved in four. Three patients reported no wound pain on removal with three reporting a 90% reduction. All patients were able to maintain compression and lymphedema therapy requirements. There were no episodes of periwound adhesive denudations.

Conclusion: Use of a superabsorbent non-adhesive wound dressing can reduce costs to home-health agencies, providers in capitated management systems and patients whose dressings are not covered under their insurance as dressing frequencies are reduced. Other potential cost savings can be achieved with reduced peri-wound maceration and trauma. Further study is warranted.

*Allevyn Gentle Border, Smith & Nephew, Key Largo, Florida

** Mepilex Border, Molnlyke Healthcare, Norcross, Georgia

*** Optilock, Medline Industries, Mundelein, Illinois