PMID- 18936373
OWN - NLM
STAT- MEDLINE
DCOM- 20081126
LR  - 20101118
IS  - 1538-3644 (Electronic)
IS  - 0004-0010 (Linking)
VI  - 143
IP  - 10
DP  - 2008 Oct
TI  - Occlusive vs gauze dressings for local wound care in surgical patients: a 
      randomized clinical trial.
PG  - 950-5
LID - 10.1001/archsurg.143.10.950 [doi]
AB  - OBJECTIVE: To compare effectiveness and costs of gauze-based vs occlusive, 
      moist-environment dressing principles. DESIGN: Randomized clinical trial. 
      SETTING: Academic Medical Center, Amsterdam, the Netherlands. PATIENTS: Two 
      hundred eighty-five hospitalized surgical patients with open wounds. 
      INTERVENTION: Patients received occlusive (ie, foams, alginates, hydrogels, 
      hydrocolloids, hydrofibers, or films) or gauze-based dressings until their wounds 
      were completely healed. MAIN OUTCOME MEASURES: Primary end points were complete 
      wound healing, pain during dressing changes, and costs. Secondary end point was 
      length of hospital stay. RESULTS: Time to complete wound healing did not differ 
      significantly between occlusive (median, 66 days; interquartile range [IQR], 
      29-133 days) and gauze-based dressing groups (median, 45 days; IQR, 26-106 days; 
      log-rank P = .31). Postoperative wounds (62% of the wounds included) healed 
      significantly (P = .02) quicker using gauze dressings (median, 45 days; IQR, 
      22-93 days vs median, 72 days; IQR, 36-132 days). Median pain scores were low and 
      similar in the occlusive (0.90; IQR, 0.29-2.34) and the gauze (0.64; IQR, 
      0.22-1.95) groups (P = .32). Daily costs of occlusive materials were 
      significantly higher (occlusive, euro6.34 [US $9.95] vs gauze, euro1.85 [US 
      $2.90]; P < .001), but nursing time costs per day were significantly higher when 
      gauze was used (occlusive, euro1.28 [US $2.01] vs gauze, euro2.41 [US $3.78]; P < 
      .001). Total cost for local wound care per patient per day during hospitalization 
      was euro7.48 (US $11.74) in the occlusive group and euro3.98 (US $6.25) in the 
      gauze-based group (P = .002). CONCLUSIONS: The occlusive, moist-environment 
      dressing principle in the clinical surgical setting does not lead to quicker 
      wound healing or less pain than gauze dressings. The lower costs of less frequent 
      dressing changes do not balance the higher costs of occlusive materials. Trial 
      Registration trialregister.nl Identifier: 56264738.
FAU - Ubbink, Dirk T
AU  - Ubbink DT
AD  - Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Room 
      J1B-215, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, the 
      Netherlands. d.ubbink@amc.nl
FAU - Vermeulen, Hester
AU  - Vermeulen H
FAU - Goossens, Astrid
AU  - Goossens A
FAU - Kelner, Raoul B
AU  - Kelner RB
FAU - Schreuder, Sanne M
AU  - Schreuder SM
FAU - Lubbers, Maarten J
AU  - Lubbers MJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
SB  - IM
CIN - Evid Based Nurs. 2009 Apr;12(2):52. PMID: 19321829
MH  - Academic Medical Centers
MH  - Adult
MH  - Bandages/*economics/*statistics & numerical data
MH  - Bandages, Hydrocolloid/economics/statistics & numerical data
MH  - Cost Savings
MH  - Female
MH  - Follow-Up Studies
MH  - *Hospital Costs
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Netherlands
MH  - Occlusive Dressings/economics/statistics & numerical data
MH  - Pain Measurement
MH  - Patient Satisfaction
MH  - Probability
MH  - Reference Values
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Statistics, Nonparametric
MH  - Surgical Procedures, Operative/methods/mortality
MH  - Surgical Wound Infection/*prevention & control/therapy
MH  - Wound Healing/*physiology
MH  - Wounds and Injuries/therapy
EDAT- 2008/10/22 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/10/22 09:00
PHST- 2008/10/22 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/10/22 09:00 [entrez]
AID - 143/10/950 [pii]
AID - 10.1001/archsurg.143.10.950 [doi]
PST - ppublish
SO  - Arch Surg. 2008 Oct;143(10):950-5. doi: 10.1001/archsurg.143.10.950.