• Dirk T Ubbink, Hester Vermeulen, Astrid Goossens, Raoul B Kelner, Sanne M Schreuder, and Maarten J Lubbers.
• Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Room J1B-215, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, the Netherlands. d.ubbink@amc.nl
• Arch Surg. 2008 Oct 1;143(10):950-5.

ObjectiveTo compare effectiveness and costs of gauze-based vs occlusive, moist-environment dressing principles.DesignRandomized clinical trial.SettingAcademic Medical Center, Amsterdam, the Netherlands.PatientsTwo hundred eighty-five hospitalized surgical patients with open wounds.InterventionPatients received occlusive (ie, foams, alginates, hydrogels, hydrocolloids, hydrofibers, or films) or gauze-based dressings until their wounds were completely healed.Main Outcome MeasuresPrimary end points were complete wound healing, pain during dressing changes, and costs. Secondary end point was length of hospital stay.ResultsTime to complete wound healing did not differ significantly between occlusive (median, 66 days; interquartile range [IQR], 29-133 days) and gauze-based dressing groups (median, 45 days; IQR, 26-106 days; log-rank P = .31). Postoperative wounds (62% of the wounds included) healed significantly (P = .02) quicker using gauze dressings (median, 45 days; IQR, 22-93 days vs median, 72 days; IQR, 36-132 days). Median pain scores were low and similar in the occlusive (0.90; IQR, 0.29-2.34) and the gauze (0.64; IQR, 0.22-1.95) groups (P = .32). Daily costs of occlusive materials were significantly higher (occlusive, euro6.34 [US $9.95] vs gauze, euro1.85 [US $2.90]; P < .001), but nursing time costs per day were significantly higher when gauze was used (occlusive, euro1.28 [US $2.01] vs gauze, euro2.41 [US $3.78]; P < .001). Total cost for local wound care per patient per day during hospitalization was euro7.48 (US $11.74) in the occlusive group and euro3.98 (US $6.25) in the gauze-based group (P = .002).ConclusionsThe occlusive, moist-environment dressing principle in the clinical surgical setting does not lead to quicker wound healing or less pain than gauze dressings. The lower costs of less frequent dressing changes do not balance the higher costs of occlusive materials. Trial Registration trialregister.nl Identifier: 56264738.

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