MANAGED CARE November 2009. ©MediMedia USA
Inexpensive wound dressings used to promote healing of venous leg ulcers have been shown to be just as effective as the more expensive antimicrobial silver dressings, according to a study published in the British Journal of Surgery. The study demonstrated that routinely using the inexpensive dressings could save the National Health Service of the United Kingdom millions of pounds a year. Could the same be said across the Atlantic?
“There’s very little data to show that silver dressings are better than the inexpensive variety,” says Anil Hingorani, MD, an associate professor of surgery at the State University of New York (SUNY) Downstate Medical Center. “The simple compression dressing is the gold standard.”
In the British study, researchers followed 213 leg ulcer patients who received either standard low-adhesive dressings or antimicrobial silver dressings. The group that received the silver dressings had a median healing time of 67 days, while the control group had a median healing time of 58 days. The patients were followed for one year, with 96 percent of patients from both groups showing ulcer healing. But the average cost of treating a patient with silver dressings was £417.97 (about U.S. $682), including staff time and materials — about 30 percent higher than the £320.12 (about U.S. $522) it cost for the group that received the standard compression dressings.
“First-line therapy for these wounds is to use compression dressings, but I can understand the appeal of the antimicrobial silver dressings because they are newer,” says Hingorani. Although it is the surgeon’s decision as to which type of dressing to use, “health plans are hesitant to pay for the silver dressings because data demonstrating their cost-effectiveness have been scarce,” he says.