PMID- 33279277 OWN - NLM STAT- MEDLINE DCOM- 20211025 LR - 20211025 IS - 1768-319X (Electronic) IS - 0294-1260 (Linking) VI - 66 IP - 1 DP - 2021 Feb TI - [ALGINATE versus negative-pressure therapy: Comparison of the clinical effectiveness, tolerance and costs in management of patients after surgical excision. Multicenter, randomized non-inferiority clinical trial on 113 patients]. PG - 3-9 LID - S0294-1260(20)30166-7 [pii] LID - 10.1016/j.anplas.2020.11.001 [doi] AB - INTRODUCTION: Pure calcium alginate dressing (ALGINATE) and Negative Pressure Wound Therapy (NPWT) are frequently used for the preparation of skin excisions for a split thickness skin graft take. The trial compared the healing efficacy, safety and cost of patient care for these two treatments. PATIENTS AND METHODS: This randomized, non-inferiority trial enrolled 113 patients who underwent skin excision (>30 cm(2)) and received ALGINATE or NPWT. The primary outcome was the time to obtain optimal granulation tissue for a split thickness skin graft take. Secondary outcomes were the occurrence of adverse events (AEs) and the impact of the patient care cost on the Social Security budget. RESULTS: The mean time to optimal granulation was similar between ALGINATE and NPWT: approximately 20 days. No AE was reported with ALGINATE while 24 % of patients treated with NPWT presented an AE. Following hospitalization, 94 % of ALGINATE patients were cared for at home by a private nurse, while 90 % of NPWT patients were followed up in aftercare and rehabilitation facilities or home hospitalization. Therefore, the cost of treatment per patient for the French Social Security was 498 euro with ALGINATE and 2104 euro with NPWT. CONCLUSION: This trial has demonstrated that ALGINATE has a similar healing efficacy to that of NPWT, and that it is markedly better with regard to patient safety and cost savings. ALGINATE should therefore be preferred to NPWT in this indication. CI - Copyright (c) 2020 Elsevier Masson SAS. All rights reserved. FAU - Guerreschi, P AU - Guerreschi P AD - Departement de chirurgie plastique, esthetique et reconstructrice, CHRU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France. FAU - Casanova, D AU - Casanova D AD - Departement de chirurgie plastique et reconstructrice, hopital La-Conception, 147, boulevard Baille, 13005 Marseille, France. FAU - Maunoury, F AU - Maunoury F AD - STATESIA, 19, rue Gougeard, 72530 Yvre-l'Eveque, France. FAU - Sinna, R AU - Sinna R AD - Departement de chirurgie plastique, esthetique et reconstructrice, CHU d'Amiens-Picardie, 1, rue du Professeur-Christian-Cabrol, 80054 Amiens, France. FAU - Revol, M AU - Revol M AD - Universite de Paris, UFR Villemin, 75010 Paris, France. Electronic address: mrevol05@gmail.com. LA - fre PT - Journal Article PT - Multicenter Study TT - ALGINATE versus traitement par pression negative : comparaison de l'efficacite, de la tolerance et des couts de prise en charge de patients apres exerese chirurgicale. Etude clinique multicentrique, randomisee de non-inferiorite sur 113 patients. DEP - 20201202 PL - France TA - Ann Chir Plast Esthet JT - Annales de chirurgie plastique et esthetique JID - 8305839 RN - 0 (Alginates) SB - IM MH - *Alginates MH - Bandages MH - Humans MH - *Negative-Pressure Wound Therapy MH - Skin Transplantation MH - Treatment Outcome OTO - NOTNLM OT - Alginate de calcium OT - Calcium alginate dressing OT - Cost of patient care OT - Couts de prise en charge OT - Exerese chirurgicale OT - Negative Pressure Wound Therapy OT - Skin excision OT - Traitement par pression negative EDAT- 2020/12/07 06:00 MHDA- 2021/10/26 06:00 CRDT- 2020/12/06 20:41 PHST- 2020/11/06 00:00 [received] PHST- 2020/11/18 00:00 [accepted] PHST- 2020/12/07 06:00 [pubmed] PHST- 2021/10/26 06:00 [medline] PHST- 2020/12/06 20:41 [entrez] AID - S0294-1260(20)30166-7 [pii] AID - 10.1016/j.anplas.2020.11.001 [doi] PST - ppublish SO - Ann Chir Plast Esthet. 2021 Feb;66(1):3-9. doi: 10.1016/j.anplas.2020.11.001. Epub 2020 Dec 2.