A plant-derived wound therapeutic for cost-effective treatment of post-surgical scalp wounds with exposed bone.
BACKGROUND
To evaluate efficacy and cost-effectiveness of a plant-derived wound dressing (ONE), a mixture of hypericum oil (Hypericum perforatum L.) and neem oil (Azadirachta indica A. Juss.), in scalp wounds with exposed bone.


METHODS
All patients with scalp wounds with exposed bone, following the excision of skin tumors, and treated with ONE in 2011 were included. Time of healing, wound size, area of exposed bone, ease of handling, pain, and complications were evaluated. Costs of dressings and nursing time were compared with those cited in literature for other treatment modalities.


RESULTS
Fifteen consecutive patients with a mean age of 76.87 ± 10.3 years (59-90 years) were analyzed. The mean wound size was 10.9 ± 6.84 cm(2) (0.4-22.6 cm(2)) with 4.8 ± 5.9 cm(2) (0.3-20.7 cm(2)) of exposed bone. The time of complete healing by secondary intention was 8.1 (4-20) weeks. Rapid formation of granulation tissue was observed which after 4 weeks covered the entire exposed bone surface in 11 of 15 cases (73%). Dressing change was simple with no pain reported; no infections or other complications occurred. Using ONE for a mean healing time of 56.7 days resulted in mean costs of EUR 423.73, which is substantially lower than those published for fascia lata, negative pressure therapy, or collagen matrix followed by skin grafting (EUR 1,612.82, EUR 4,411.80 and EUR 1,503.72, respectively).


CONCLUSIONS
This retrospective, non-controlled analysis supports ONE as a simple-to-use and safe treatment option for scalp wounds with exposed bone. Treatment costs compare favorably to those published for other treatment modalities.
Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Severin
S
Läuchli
Stefanie
S
Vannotti
Jürg
J
Hafner
Thomas
T
Hunziker
Lars
L
French
D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D005260:Female; D005989:Glycerides / Q000627:therapeutic use*; D006801:Humans; D020902:Hypericum; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000191:economics* / Q000379:methods*; D010936:Plant Extracts / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies; D012535:Scalp / Q000187:drug effects* / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery*; D013557:Switzerland; D013729:Terpenes / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects*
D004338:Drug Combinations; D005989:Glycerides; D010936:Plant Extracts; D013729:Terpenes; C002443:neem oil