Wound Digest Digest
Skin integrity 2
Relative cost-effectiveness of a skin protectant in managing venous leg ulcers
in the UK
Readability Relevance to daily practice Novelty factor
n Skin protection in patients with compromised skin integrity can help prevent damage to tissue, aid in healing and decrease the risk of expensive complications.
n The objective of this study was to estimate the clinical and cost-effectiveness of using a skin protectant (Cavilon No Sting Barrier Film [NSBF] or Cavilon Durable Barrier Cream [DBC]; 3M) compared with not using a skin protectant during the management of venous leg ulcers in the UK.
n The authors designed a decision model depicting the patient pathways and associated management of patients with and without a Cavilon film or cream, plus dressings and compression. The model — based on the case records of a cohort of patients from The Health Improvement Network (THIN) database, diagnosed with a venous leg ulcer between 1 January, 2008 and 31 December, 2009 — estimated patient
management costs and outcomes over six months, as well as the cost-effectiveness of using a Cavilon formulation compared with a skin protectant.
n It was found that healing was affected by a patient’s age, but that gender, level of exudate or wound size were not determining factors. There was a significantly greater reduction in wound size among patients in the NSBF group than in the other two groups (p<0.001).
n There was no significant difference in the initial wound size of the venous leg ulcers that did and did not heal in the two Cavilon groups. The initial size of the healed ulcers in the control group was significantly smaller than those that did not (p<0.001).
n Patients were predominantly managed by practice nurses, with a mean 37–38 nurse visits over the study period. Patients’ dressings were changed, on average, every 4–5 days, with a mean of three dressings under a compression bandage.
n Resource use was similar between the groups. The total six-month cost for the NHS of managing a VLU was approximately £2,200.
n Use of NSBF leads to greater wound size reduction and may facilitate the healing of larger wounds, without increased costs.
Guest JF, Taylor RR, Vowden K, Vowden P, M Collier C. Relative cost-effectiveness of a skin protectant in managing venous leg ulcers in the UK. J Wound Care 2012; 21(8):389–94, 396–8.
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