title: Modelling the cost implications of using carboxymethylcellulose dressing compared with gauze in the management of surgical wounds healing by secondary intention in the US and UK.
abstract: OBJECTIVE
  To estimate the costs of using carboxymethyl cellulose dressing (CMCD; Aquacel* Hydrofiber) compared to gauze in managing surgical wounds healing by secondary intention in the US and UK.
  
  
  METHODS
  This was a modelling study performed from the perspective of payers (i.e. the hospital and community sector in the US and the National Health Service (NHS) in the UK).
  
  
  METHODS
  Clinical outcomes attributable to managing surgical wounds healing by secondary intention with gauze were obtained from the published literature in the English language. There were no published studies on wounds healing by secondary intention with CMCD. Hence, the analysis conservatively assumed that wound healing rates associated with gauze would be the same for CMCD. These data were combined with resource utilisation estimates derived from a panel of clinicians enabling us to perform decision modelling. The models were used to determine the expected direct healthcare costs eight weeks after the surgical wounds were dressed by CMCD or gauze and left to heal by secondary intention in the US and UK.
  
  
  RESULTS
  All wounds are expected to heal within eight weeks, irrespective of dressing. Managing abscesses and other surgical wounds with CMCD instead of gauze in the US is expected to reduce costs by 4% in both wound types (i.e. $247 and $507 respectively) per patient over eight weeks. In the UK, managing abscesses and other surgical wounds with CMCD instead of gauze is expected to reduce costs by 30% (574 pounds) and 12% (581 pounds) respectively per patient over eight weeks. The lower cost of managing CMCD-treated patients is due to decreased nursing costs associated with a lower frequency of CMCD changes compared to gauze dressing changes.
  
  
  CONCLUSIONS
  Dressing surgical wounds healing by secondary intention with CMCD instead of gauze is expected to lead to a reduction in healthcare costs in both the US and UK. Hence, the purchase price of a dressing is not indicative of the cost effectiveness of a given method of surgical wound care.
authors.affiliation: CATALYST Health Economics Consultants, Northwood, Middlesex, UK. julian.guest@catalyst-health.co.uk
authors.forename: Julian F
authors.initials: JF
authors.lastname: Guest
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Ruiz
mesh_terms: D047070:Bandages, Hydrocolloid / Q000191:economics*; D002266:Carboxymethylcellulose Sodium / Q000191:economics / Q000627:therapeutic use*; D003646:Debridement; D017048:Health Care Costs; D006801:Humans; D017059:Models, Econometric; D009779:Occlusive Dressings / Q000191:economics*; D011182:Postoperative Care / Q000191:economics; D017592:Skin Care / Q000191:economics; D013530:Surgical Wound Infection / Q000191:economics* / Q000628:therapy*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome; D006113:United Kingdom; D014481:United States; D014945:Wound Healing
chemical_list: D002266:Carboxymethylcellulose Sodium