Cost-effective managed care: gel versus wet-to-dry for debridement.

Cost-effective managed care must take into consideration all funds expended for treatment, including related materials and labor from treatment initiation until treatment endpoint is attained. The cost-effective debridement of a chronic wound is dependent on the total labor and materials cost entailed from initiation of treatment up to the transition period (time when the wound is debrided). The purpose of this analysis was to compare the cost of a hypertonic hydrogel with polyurethane secondary dressing to a saline moistened gauze (standard wet-to-dry technique) as debriding agents for dry eschar. The results showed that the daily cost of treatment was slightly higher with the hydrogel/polyurethane method than with the wet-to-dry method. However, the hydrogel/polyurethane method was a more cost-effective means of debriding these wounds when taking into account the time required to reach > or = 50 percent debridement along with time to change dressings and amount of materials needed. Considerations in choosing a treatment modality must include product cost along with average number of treatment days required to reach the treatment goal. This study shows that neither individual cost nor daily cost of a material may necessarily dictate overall cost-effectiveness.