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Erschienen in: Clinical Drug Investigation 5/2000

01.05.2000 | Clinical Pharmacoeconomics

Cost, Efficacy, Efficiency and Tolerability of Collagenase Ointment versus Hydrocolloid Occlusive Dressing in the Treatment of Pressure Ulcers

A Comparative, Randomised, Multicentre Study

verfasst von: Dr Angel Burgos, J. Giménez, E. Moreno, E. Lamberto, M. Utrera, E. M. Urraca, F. J. Vélez, E. López, M. A. Martínez, M.J. Gómez, L. García

Erschienen in: Clinical Drug Investigation | Ausgabe 5/2000

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Abstract

Objective: Pressure ulcers are a common and costly healthcare problem. It is imperative to devise treatment methods that are simultaneously efficacious and cost effective. The efficacy and tolerability of collagenase ointment and hydrocolloid occlusive dressing have been proven in the treatment of pressure ulcers, but no comparative cost-efficacy studies have been reported. The present study was carried out to compare the cost, efficacy, efficiency and tolerability of these two methods.
Design and Setting: This was a multicentre, randomised, nonblind, parallel group study conducted at seven hospitals in Spain.
Patients: 37 evaluable patients of either gender aged 55 years or over having had stage III pressure ulcers for <1 year.
Methods: Reduction of ulcer area assessed at 1-week intervals was the primary outcome measure. Pain, granulation tissue, exudate and odour were also evaluated, as were nutrition state and occurrence of adverse reactions.
Results: No statistically significant differences in cost, efficacy or efficiency were detected between collagenase ointment and hydrocolloid dressing in the treatment of pressure ulcers, although a trend for better efficacy and efficiency of collagenase treatment was observed. The tolerability of both therapeutic regimens was good.
Conclusions: These findings indicate that collagenase ointment and hydrocolloid dressing produced similar healing effects in patients with pressure ulcers.
Fußnoten
1
1The sale price was the public selling price, i.e. the price a patient would pay if the product was bought in a pharmacy.
 
2
2We assumed an annual salary of Pta2,800,000 plus 34% social security contribution. We also assumed 240 working days/year and 8 hours/day.
 
Literatur
1.
Zurück zum Zitat Hatz RA, Niedner R, Vansheidt W, et al. Wound healing and wound management. Berlin: Springer-Verlag, 1994CrossRef Hatz RA, Niedner R, Vansheidt W, et al. Wound healing and wound management. Berlin: Springer-Verlag, 1994CrossRef
2.
Zurück zum Zitat Pressure ulcers. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service/US Department of Health and Human Services, AHCPR Publication no. 95-0652, 1994 Pressure ulcers. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service/US Department of Health and Human Services, AHCPR Publication no. 95-0652, 1994
3.
Zurück zum Zitat Jung W, Winter H. Considerations for the use of clostridial collagenase in clinical practice. Clin Drug Invest 1998; 15: 245–52CrossRef Jung W, Winter H. Considerations for the use of clostridial collagenase in clinical practice. Clin Drug Invest 1998; 15: 245–52CrossRef
4.
Zurück zum Zitat Sinclair RD, Ryan TJ. Types of chronic wounds: indications for enzymatic debridement. In: Westerhof W, Vanscheldt W, editors. Proteolytic enzymes and wound healing. Berlin: Springer, 1994: 7–21CrossRef Sinclair RD, Ryan TJ. Types of chronic wounds: indications for enzymatic debridement. In: Westerhof W, Vanscheldt W, editors. Proteolytic enzymes and wound healing. Berlin: Springer, 1994: 7–21CrossRef
5.
Zurück zum Zitat Ranzati C, Zahn W, Thorn H. Bacterial collagenase and collagen breakdown products exert chemotactic effects in vitro: implication for wound débridement and wound healing [abstract no. 37]. 4th Annual Meeting of the European Tissue Repair Society, 1994 Aug 25–28: Oxford, England, 1994 Ranzati C, Zahn W, Thorn H. Bacterial collagenase and collagen breakdown products exert chemotactic effects in vitro: implication for wound débridement and wound healing [abstract no. 37]. 4th Annual Meeting of the European Tissue Repair Society, 1994 Aug 25–28: Oxford, England, 1994
6.
Zurück zum Zitat Herman IM. Stimulation of human keratinocyte migration and proliferation in vitro: insights into the cellular responses to injury and wound healing. Wounds 1996; 8: 33 Herman IM. Stimulation of human keratinocyte migration and proliferation in vitro: insights into the cellular responses to injury and wound healing. Wounds 1996; 8: 33
7.
Zurück zum Zitat Cortivo R, Radice M, Brun P, et al. Biological activity of human collagen breakdown products of fibroblasts. Wounds 1995; 7: 38A Cortivo R, Radice M, Brun P, et al. Biological activity of human collagen breakdown products of fibroblasts. Wounds 1995; 7: 38A
8.
Zurück zum Zitat Porres-Reyes BH, Blair HC, Jeffrey JJ, et al. Collagenase production at the border of granulation tissue in a healing wound: macrophage and mesenchymal collagenase production in vivo. Connect Tissue Res 1991; 27: 63CrossRef Porres-Reyes BH, Blair HC, Jeffrey JJ, et al. Collagenase production at the border of granulation tissue in a healing wound: macrophage and mesenchymal collagenase production in vivo. Connect Tissue Res 1991; 27: 63CrossRef
9.
Zurück zum Zitat Cohen IK, Diegelmann RF, Lindblad WJ, editors. Wound healing: biochemical and clinical aspects. Philadelphia: WB Saunders Company, 1992 Cohen IK, Diegelmann RF, Lindblad WJ, editors. Wound healing: biochemical and clinical aspects. Philadelphia: WB Saunders Company, 1992
10.
Zurück zum Zitat Peacocke M, Gilchrest B. Cutaneous aging: cellular and molecular studies. In: Abatangelo G, Davidson JM, editors. Cutaneous development, aging and repair. Fidia Research Series. Padova: Liviana Press, 1989; 118: 263 Peacocke M, Gilchrest B. Cutaneous aging: cellular and molecular studies. In: Abatangelo G, Davidson JM, editors. Cutaneous development, aging and repair. Fidia Research Series. Padova: Liviana Press, 1989; 118: 263
11.
Zurück zum Zitat Palmieri B, Magri M. A new formulation of collagenase ointment (Iruxol® Mono) in the treatment of ulcers of the lower extremities. A randomised, placebo-controlled, double-blind study. Clin Drug Invest 1998; 15: 381–7CrossRef Palmieri B, Magri M. A new formulation of collagenase ointment (Iruxol® Mono) in the treatment of ulcers of the lower extremities. A randomised, placebo-controlled, double-blind study. Clin Drug Invest 1998; 15: 381–7CrossRef
12.
Zurück zum Zitat Alfisi M, Ferrante A, Veneziani A, et al. Kollagenasehaltiges enzympräparat für die wundreinigune bei ulzera unterschiedlicher genese. Der Kassenarzt 1986; 42: 44–50 Alfisi M, Ferrante A, Veneziani A, et al. Kollagenasehaltiges enzympräparat für die wundreinigune bei ulzera unterschiedlicher genese. Der Kassenarzt 1986; 42: 44–50
13.
Zurück zum Zitat Garcia J. Desbridamiento y curación de úlceras por presión [abstract no. 48]. I Congreso Internacional de Enfermería Geriátrica. 1997 May 28–31: Barcelona, 1997 Garcia J. Desbridamiento y curación de úlceras por presión [abstract no. 48]. I Congreso Internacional de Enfermería Geriátrica. 1997 May 28–31: Barcelona, 1997
14.
Zurück zum Zitat Helaly P, Vogt E, Schneider G. Wundheilungsstörungen und ihre enzmatische therapie eine multizentrische doppelblinstudie. Schwz Rundsch Med Praxis 1988; 77: 1428–34 Helaly P, Vogt E, Schneider G. Wundheilungsstörungen und ihre enzmatische therapie eine multizentrische doppelblinstudie. Schwz Rundsch Med Praxis 1988; 77: 1428–34
15.
Zurück zum Zitat Van Leen MWF. Collagenase treatment of chronic ulcers. 46th Congresso Nazionale delia Societa Italiana di Chirurgia Plastica Ricostruttiva ed Estetica & the European Tissue Repair Society Focus Meeting. 1997 Sep 30–Oct 3: Venezia, 1997 Van Leen MWF. Collagenase treatment of chronic ulcers. 46th Congresso Nazionale delia Societa Italiana di Chirurgia Plastica Ricostruttiva ed Estetica & the European Tissue Repair Society Focus Meeting. 1997 Sep 30–Oct 3: Venezia, 1997
16.
Zurück zum Zitat Winter GD. Formation of the scab and the rate of epithelisation of superficial wounds in the skin of the young domestic pig. J Wound Care 1995; 4: 366–71PubMed Winter GD. Formation of the scab and the rate of epithelisation of superficial wounds in the skin of the young domestic pig. J Wound Care 1995; 4: 366–71PubMed
17.
Zurück zum Zitat Stotts NA. Impaired wound healing. In: Carried Kholman V, Lindsay AM, editors. Pathophysiological phenomena in nursing: human response to illness. Philadelphia: Saunders, 1993: 443–69 Stotts NA. Impaired wound healing. In: Carried Kholman V, Lindsay AM, editors. Pathophysiological phenomena in nursing: human response to illness. Philadelphia: Saunders, 1993: 443–69
18.
Zurück zum Zitat Rijswijk LV, Brown D, Friedman S, et al. Multicenter clinical evaluation of a hydrocolloid dressing for leg ulcers. Cutis 1985; 35: 173–6PubMed Rijswijk LV, Brown D, Friedman S, et al. Multicenter clinical evaluation of a hydrocolloid dressing for leg ulcers. Cutis 1985; 35: 173–6PubMed
19.
Zurück zum Zitat Baxter R. Varihesive and the treatment of chronic leg ulcers. Aust Fam Physician 1980; 9: 599–601PubMed Baxter R. Varihesive and the treatment of chronic leg ulcers. Aust Fam Physician 1980; 9: 599–601PubMed
20.
Zurück zum Zitat Colwell JC, Foreman MD, Trotter JP A comparison of the efficacy and cost-effectiveness of two methods of managing pressure ulcers. Decubitus 1993; 6: 28–36PubMed Colwell JC, Foreman MD, Trotter JP A comparison of the efficacy and cost-effectiveness of two methods of managing pressure ulcers. Decubitus 1993; 6: 28–36PubMed
21.
Zurück zum Zitat Ohlsson P, Larsson K, Lindholm C, et al. A cost-effectiveness study of leg ulcer treatment in primary care. Comparison of saline-gauze and hydrocolloid treatment in a prospective, randomized study. Scand J Prim Health Care 1994; 12: 295–9PubMedCrossRef Ohlsson P, Larsson K, Lindholm C, et al. A cost-effectiveness study of leg ulcer treatment in primary care. Comparison of saline-gauze and hydrocolloid treatment in a prospective, randomized study. Scand J Prim Health Care 1994; 12: 295–9PubMedCrossRef
22.
Zurück zum Zitat Arnold TE, Stanley JC, Fellows EP, et al. Prospective, multicenter study of managing lower extremity venous ulcers. Ann Vasc Surg 1994; 8: 356–62PubMedCrossRef Arnold TE, Stanley JC, Fellows EP, et al. Prospective, multicenter study of managing lower extremity venous ulcers. Ann Vasc Surg 1994; 8: 356–62PubMedCrossRef
23.
Zurück zum Zitat Lindholm C. Leg ulcer treatment in hospital and primary care in Sweden: cost-effective care and quality of life. Adv Wound Care 1995; 8: 48–52PubMed Lindholm C. Leg ulcer treatment in hospital and primary care in Sweden: cost-effective care and quality of life. Adv Wound Care 1995; 8: 48–52PubMed
24.
Zurück zum Zitat Kim YC, Shin JC, Park CI, et al. Efficacy of hydrocolloid occlusive dressing technique in decubitus ulcer treatment: a comparative study. Yonsei Med J 1996; 37: 181–5PubMed Kim YC, Shin JC, Park CI, et al. Efficacy of hydrocolloid occlusive dressing technique in decubitus ulcer treatment: a comparative study. Yonsei Med J 1996; 37: 181–5PubMed
25.
Zurück zum Zitat Thomas S, Banks V, Bale S, et al. Acomparison of two dressings in the management of chronic wounds. J Wound Care 1997; 6: 383–6PubMed Thomas S, Banks V, Bale S, et al. Acomparison of two dressings in the management of chronic wounds. J Wound Care 1997; 6: 383–6PubMed
26.
Zurück zum Zitat Bergstrom N, Braden B. A prospective study of pressure sore risk among institutionalized elderly. J Am Geriatr Soc 1992; 40: 747–58PubMed Bergstrom N, Braden B. A prospective study of pressure sore risk among institutionalized elderly. J Am Geriatr Soc 1992; 40: 747–58PubMed
27.
Zurück zum Zitat Hanan K, Scheele L. Albumin vs weight as a predictor of nutritional status and pressure ulcer development. Ostomy Wound Manage 1991; 33: 22–7PubMed Hanan K, Scheele L. Albumin vs weight as a predictor of nutritional status and pressure ulcer development. Ostomy Wound Manage 1991; 33: 22–7PubMed
28.
Zurück zum Zitat Holmes R, Macchiano K, Jhangani SS, et al. Nutrition know-how: combating pressure sores nutritionally. Am J Nurs 1987; 87: 1301–3PubMed Holmes R, Macchiano K, Jhangani SS, et al. Nutrition know-how: combating pressure sores nutritionally. Am J Nurs 1987; 87: 1301–3PubMed
29.
Zurück zum Zitat Pinchcofsky-Devin GB, Kaminsky Jr MV. Correlation of pressure sores and nutritional status. J Am Geriatr Soc 1986; 34: 435–40PubMed Pinchcofsky-Devin GB, Kaminsky Jr MV. Correlation of pressure sores and nutritional status. J Am Geriatr Soc 1986; 34: 435–40PubMed
Metadaten
Titel
Cost, Efficacy, Efficiency and Tolerability of Collagenase Ointment versus Hydrocolloid Occlusive Dressing in the Treatment of Pressure Ulcers
A Comparative, Randomised, Multicentre Study
verfasst von
Dr Angel Burgos
J. Giménez
E. Moreno
E. Lamberto
M. Utrera
E. M. Urraca
F. J. Vélez
E. López
M. A. Martínez
M.J. Gómez
L. García
Publikationsdatum
01.05.2000
Verlag
Springer International Publishing
Erschienen in
Clinical Drug Investigation / Ausgabe 5/2000
Print ISSN: 1173-2563
Elektronische ISSN: 1179-1918
DOI
https://doi.org/10.2165/00044011-200019050-00006

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