by Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC
by Aletha Tippett MD
Does wound care need to be expensive? In the U.S. over a billion dollars per year is spent on wound care. When dealing on an individual basis, the cost of treating a pressure ulcer, our most common type of wound, has been computed to be $1600/patient/month, adjusted for CPI.1 What is driving this trend? It is expensive, high tech equipment such as pressurized beds, vacuum assisted closure, surgical techniques for debridement and skin grafting, and high priced dressings such as some of the foams, alginates and collagen dressings. Additionally, costs are increased when care is ineffective or counter-productive, prolonging the need for care.
It is possible, and increasingly necessary, to get good results without breaking the bank. There are many inexpensive ways to provide good wound care. Support surfaces do not need to be the powered, air blown expensive contraptions; simple static air devices cost less than $1 per day and provide impressive outcomes, better than many high end brands. See results below with use of alternating pressure pads pre-wound program, and static air post-wound program.2
© HMP Communications, LLC. Used with permission.
For surgical needs, if wound debridement is required, consider maggot therapy which costs $150, much less than a trip to the OR with surgery. The maggot therapy also promotes wound healing in addition to debriding the wound. For grafting, consider cadaver skin, much less expensive than other grafting materials or split skin grafting, with very acceptable results.
Wound dressings do not need to be very expensive. One can always use gauze as a base, which costs only pennies. Then one can add whatever is needed or desired—lidocaine or morphine for pain relief, powdered antibiotics for infection and odor control, honey for natural antibiotic and moisture, silver ointment for antimicrobial effect. Simple zinc oxide ointment such as Balmex can provide moisture protection of the periwound, and can provide support for a simple top dressing. Instead of an expensive top dressing with adhesives or tape that can injure the skin, a sheet of plastic wrap can be used for a top dressing, pressed into the zinc oxide ointment to hold it in place. This helps retain moisture and heat, both healing properties. Not only is this very inexpensive (pennies) it also avoids additional injury to the skin.
Odor control management can be with ground metronidazole, polysporin powder, honey, oil of wintergreen—all effective and inexpensive.
Highly exudative/draining wounds can be very expensive to cover with absorbent dressings. One of the best products for absorbency is infant disposable diapers. They are designed to wick fluid away from the body, absorb a tremendous amount, and have an outer protective sheet. The diapers come in different sizes and can be cut to fit. They cost a fraction of some of the absorbent dressings.
Treating wounds as described above can reduce costs to a third or less, spending only a few hundred dollars or less each month. And results can be very gratifying as shown in the below graph where these techniques were used on 72 patients with 156 wounds, Stages II-IV (unpublished data).
It is important that all of us look for ways to conserve our resources and be good stewards to assure the future for good health and wound care. Do not overlook common things around you for inspiration, and embrace the opportunity to use inexpensive options.
1. Xakellis, G. and Frantz, R. The cost of healing pressure ulcers across multiple health care settings. Advances in Wound Care, 1996: Vol. 9, No. 6. pp 18-22.
2. Tippett, A. Reducing the Incidence of Pressure Ulcers in Nursing Home Residents: A Prospective 6-Year Evaluation. OWM, Nov 2009. pp 52-58.
About The Author
Aletha Tippett MD is a family medicine and wound care expert, founder and president of the Hope of Healing Foundation®, family physician, and international speaker on wound care.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.