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Case Study
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Cost-effective use of silver impregnated open-celled, reticulated polyurethane foam in full-thickness ulcers Jean M. deLeon, MD, Melody Nagel, PT, Michelle Fudge, PT, Adora Lucius, CWOCN, Nancy Sweeney May, WOCN, Betty Garcia Bacterial resistance to antibiotics has created renewed interest in silver products. The question of which product provides the most benefit and which has the optimal dosing of silver is a controversial topic. The healing rates of two patients with colonized full-thickness wounds were evaluated for the effectiveness of VAC therapy with adjunctive silver products versus VAC therapy with silver impregnated open-celled, reticulated polyurethane foam. The patient with a chronic (present >1 year) stage IV sacral pressure ulcer treated 3 years ago with an adjunctive silver dressing and VAC therapy closed an area of 5.04cm2 and a volume of 1.9 cm3 at a rate of 0.07 cm2/day and 0.03 cm3/day. She was readmitted for the same ulcer this year and treated with the impregnated foam. She closed an area of 3.14cm2 and a volume of 11.26 cm3 at a rate of 0.21 cm2/day and 0.75 cm3/day, representing a 3 fold improvement in area healing rate and a 25 fold improvement in volume healing rate. The original cost per outcome was $20.0/cm2 and $52.9/cm3 compared to $31.9/cm2 and $8.9/cm3 using silver impregnated foam. The patient with a chronic diabetic leg ulcer (>6 weeks) was admitted twice in a 3-month period. On her initial stay, she closed an area of 1.37 cm2 and a volume of 1.53 cm3 at a rate of 0.04 cm2/day and 0.04 cm3/day. On readmission she was treated with the silver impregnated foam and closed an area of 2.95 cm2 and a volume of 3.16 cm3 at a rate of 0.20 cm2/day and 0.21 cm3/day, representing a 5 fold improvement in area and volume healing rates. The initial cost per outcome was $60.49/cm2 and $54.16/cm3 compared to $36.05/cm2 and $33.65/cm3 using silver impregnated foam. Both cases demonstrated a clear improvement in healing rate as well as a cost effective strategy. |
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