Costs of topical therapy in hospitalized patients with chronic wounds

Aim: To analyze the direct costs of topical therapies used in chronic wounds of hospitalized patients. Method: this is a prospective, descriptive and exploratory study, carried out in a general hospital in São Paulo state, Brazil. The sample was composed by 37 patients with 55 chronic wounds from different etiologies, who were hospitalized between July and October 2009. The study was approved by Hospital Ethics Committee. Selected patients were evaluated for wound healing evolution, consumption of materials and wound care time, while patients were admitted and or wounds duration. Wound healing process was assessed through Pressure Ulcer Scale for Healing tool. Materials used for topical treatment and time spent for local wound care were registered. Materials prices were identified by Purchasing Sector of Hospital. Direct costs were calculated by the sum of three categories: cleaning, dressings and technical procedures. For statistical analysis, Pearson´s correlation, t-paired test and linear logistic regression were performed. Results: The sample was mostly composed by men (22/ 59.5%), 57.9 ± 20.8 years old, with average 1.5 ± 1.5 wound per patient and 18.3 ± 23.9 follow up days. Out of 55 wounds, 37 (67.3%) were pressure ulcer (PU), 8 (14.5%) vascular and diabetic (UV/D) and others (10/18.2%). Total cost of  topical therapies was US$5949.59, 51.5% related to cleaning costs; 32.6% were dressings’ costs and 15.9% for technical procedures. Costs related to PU topical therapy represented 77.7% of total, 6.3% for UV/D and 16% for other wounds. Costs were significantly higher for the follow up greater than 16 days (p=0.039). Conclusion: The results reinforce the need of risk assessment actions, especially for PU, and prevention. The study showed the most important costs were related to cleaning process, PU wound care and higher follow up time.