title: The cost-benefit of using soft silicone multilayered foam dressings to prevent sacral and heel pressure ulcers in trauma and critically ill patients: a within-trial analysis of the Border Trial.
abstract: Little is known about the cost-benefit of soft silicone foam dressings in pressure ulcer (PU) prevention among critically ill patients in the emergency department (ED) and intensive care unit (ICU). A randomised controlled trial to assess the efficacy of soft silicone foam dressings in preventing sacral and heel PUs was undertaken among 440 critically ill patients in an acute care hospital. Participants were randomly allocated either to an intervention group with prophylactic dressings applied to the sacrum and heels in the ED and changed every 3 days in the ICU or to a control group with standard PU prevention care provided during their ED and ICU stay. The results showed a significant reduction of PU incidence rates in the intervention group (P = 0·001). The intervention cost was estimated to be AU$36·61 per person based on an intention-to-treat analysis, but this was offset by lower downstream costs associated with PU treatment (AU$1103·52). Therefore, the average net cost of the intervention was lower than that of the control (AU$70·82 versus AU$144·56). We conclude that the use of soft silicone multilayered foam dressings to prevent sacral and heel PUs among critically ill patients results in cost savings in the acute care hospital.
authors.affiliation: Department of Nursing, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Santamaria
authors.affiliation: Emergency Department, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Emergency Department, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Marie
authors.initials: M
authors.lastname: Gerdtz
authors.affiliation: Department of Nursing, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sage
authors.affiliation: Department of Podiatry, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: McCann
authors.affiliation: Department of Podiatry, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Freeman
authors.affiliation: Emergency Department, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Theresa
authors.initials: T
authors.lastname: Vassiliou
authors.affiliation: Department of Nursing, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Stephanie
authors.initials: S
authors.lastname: DeVincentis
authors.affiliation: Department of Nursing, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Ai W
authors.initials: AW
authors.lastname: Ng
authors.affiliation: Department of Nursing, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
authors.affiliation: Emergency Department, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Knott
authors.affiliation: EpiCentre, Royal Melbourne Hospital & University of Melbourne, Melbourne, Australia.
authors.forename: Danny
authors.initials: D
authors.lastname: Liew
mesh_terms: D001458:Bandages / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000379:methods*; D016638:Critical Illness / Q000191:economics* / Q000628:therapy; D005260:Female; D006365:Heel; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000191:economics / Q000517:prevention & control*; D012447:Sacrum; D012828:Silicones / Q000191:economics*
chemical_list: D012828:Silicones
keywords: Cost-benefit; Pressure ulcers; Prophylactic dressings
references.citation: Int Wound J. 2015 Jun;12(3):302-8
references.pmid: 23711244
references.citation: Med Care. 2011 Apr;49(4):385-92
references.pmid: 21368685
references.citation: J Wound Care. 2012 Jun;21(6):261-2, 264, 266
references.pmid: 22886290
references.citation: Am J Surg. 2010 Oct;200(4):473-7
references.pmid: 20887840
references.citation: J Adv Nurs. 2005 May;50(3):307-14
references.pmid: 15811110
references.citation: Dermatol Nurs. 2009 Sep-Oct;21(5):268-72
references.pmid: 19873692
references.citation: Int Wound J. 2013 Oct;10(5):579-84
references.pmid: 22672730
references.citation: Age Ageing. 2004 May;33(3):230-5
references.pmid: 15082426
references.citation: Ostomy Wound Manage. 2009 Feb;55(2):50-5
references.pmid: 19246785
references.citation: Ann Emerg Med. 2011 Nov;58(5):468-78.e3
references.pmid: 21820208
references.citation: Surgery. 2011 Jul;150(1):122-32
references.pmid: 21683861
references.citation: Ann Intern Med. 2010 Jun 1;152(11):726-32
references.pmid: 20335313
references.citation: Wound Repair Regen. 2005 Sep-Oct;13(5):462-7
references.pmid: 16176454
references.citation: Pharmacoeconomics. 2002;20(7):443-54
references.pmid: 12093300