Secondary Dressings Research Articles

A clinical trial of Integra Template for diabetic foot ulcer treatment.

Individuals with diabetes mellitus are at an increased risk of developing a diabetic foot ulcer (DFU). This study evaluated the safety and efficacy of Integra Dermal Regeneration Template (IDRT) for the treatment of nonhealing DFUs. The Foot Ulcer New Dermal Replacement Study was a multicenter, randomized, controlled, parallel group clinical trial conducted under an Investigational Device Exemption. Thirty-two sites enrolled and randomized 307 subjects with at least one DFU. Consented patients were entered into the 14-day run-in phase where they were treated with the standard of care (0.9% sodium chloride gel) plus a secondary dressing and an offloading/protective device. Patients with less than 30% reepithelialization of the study ulcer after the run-in phase were randomized into the treatment phase. The subjects were randomized to the control treatment group (0.9% sodium chloride gel; n = 153) or the active treatment group (IDRT, n = 154). The treatment phase was 16 weeks or until confirmation of complete wound closure (100% reepithelialization of the wound surface), whichever occurred first. Following the treatment phase, all subjects were followed for 12 weeks. Complete DFU closure during the treatment phase was significantly greater with IDRT treatment (51%) than control treatment (32%; p = 0.001) at sixteen weeks. The median time to complete DFU closure was 43 days for IDRT subjects and 78 days for control subjects in wounds that healed. The rate of wound size reduction was 7.2% per week for IDRT subjects vs. 4.8% per week for control subjects (p = 0.012). For the treatment of chronic DFUs, IDRT treatment decreased the time to complete wound closure, increased the rate of wound closure, improved components of quality of life and had less adverse events compared with the standard of care treatment. IDRT could greatly enhance the treatment of nonhealing DFUs.

New Twist on an Old Favorite: Gentian Violet and Methylene Blue Antibacterial Foams

Significance: Absorptive antibacterial dressings that assist in controlling bioburden without risks of cytotoxicity or residual absorption can be effectively used for prolonged periods throughout the wound healing continuum. Recent Advances: Until recently, gentian violet and methylene blue (GV/MB) antibacterial dressings have been commercially available only in polyvinyl alcohol (PVA) foam; polyurethane (PU) foam bonded with GV and MB with thin film backing is now commercially available. GV/MB PU foam does not require hydration or a necessary secondary dressing. GV/MB PVA and PU foam dressings were recently granted FDA clearance as antibacterial dressings, as opposed to bacteriostatic dressings as previously classified. Within the class of antibacterial dressings, GV/MB foam dressings are of lower cost alternative to silver- or iodine-based antibacterial dressings with no risk of absorption of any of the foam components into the tissues. Critical Issues: Control of wound bioburden levels by antibacterial agents and absorption of excess exudate are crucial in preventing infections that drastically increase the price of wound care. Use of GV/MB dressings may improve wound healing outcomes and decrease overall costs through super absorption, promotion of autolytic debridement, bioburden reduction, ease of use, and decreased dressing change frequency. Future Directions: Evolution in resistant bacterial strains will drive continual changes in advanced wound care products. Demand will increase for economically priced, versatile wound care dressings that assist in debridement, maintain a moist wound environment, absorb and trap bacterial debris, and decrease dressing change frequency.

The prevalence, aetiology and management of wounds in a community care area in Ireland.

This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care.

Papase as a treatment option for the overgranulating wound

Overgranulation (also commonly known as hypergranulation) is a common problem in chronic wound management. We describe a case involving a 57-year-old lady with a chronic diabetic foot ulcer, complicated with overgranulation for the past year. She was administered with various treatments, including hydrocortisone 1% cream and hydrofiber, which proved ineffective and further delayed the healing process of her ulcer. We then decided to use crushed Papase tablets applied to her ulcer after a normal saline dressing and prior to an application of secondary dressing. The patient was instructed clearly on the dressing technique to be performed daily at home and was monitored weekly in a foot care clinic. The overgranulation resolved within 5 weeks and the patient continues recieving care to promote epithelialisation.

An experience with paediatric burn wounds treated with a plant-derived wound therapeutic

To observe the efficacy of a plant-derived wound dressing (1 Primary Wound Dressing®), a mixture of hypericum and neem oil, in different types of paediatric burns. A retrospective review was conducted over the complete healing course of 9 paediatric patients with a mean age of 8.17±3.35 (1-11 years), presenting mixed, partial or full-thickness burns. The treatment applied by the wound care specialist consisted of daily cleansing of the wound with a saline solution and application of 1 Primary Wound Dressing on the whole wound surface. There was no application of a secondary dressing. The time to heal, wound size, ease of handling, pain and complications were recorded. Procedural and background pain were observed in six of the patients older than 5 years (mean age 9.6±2.39, range 8-11 years). Due to the small number of patients examined during the period studied, it was not possible to perform statistical analyses. The mean wound size was 50.76±48.32cm2 (4.63-132.0cm2). A rapid induction of granulation tissue and re-epithelialisation was observed. Time to complete healing was 16.6±4.69 days (10-22 days). No complications related to wound infection was observed. The 6 patients older than five years reported a strong relief of pain, from an initial value of 7-8 out of 10 to 0 out of 10 within the first week of treatment. This remained at the 0 out of 10 level during the second and third weeks of treatment. This retrospective, non-controlled examination suggests that 1 Primary Wound Dressing could be an effective therapy for the treatment of burn wounds, with benefits including pain reduction and simplicity of use. Further evaluations with a larger population are required to document the effectiveness of this plant-derived wound dressing in a controlled fashion. There were no external sources of funding for this study. F. Carnevali is a researcher and co-inventor of 1 Primary Wound Dressing®.

Spray-on-skin cells in burns: A common practice with no agreed protocol

ObjectivesCultured epithelial autograft (CEA) has been used for skin coverage after burn wound excision since 1981. It is used in burn units and centres throughout the UK; however, there appears to be no agreed standards of practice. We aimed to investigate the experience and current practice with its usage in the management of acute burn injury. MethodsAn online survey was sent to twenty-five burns consultants in the UK, who are members of the British Burn Association. ResultsWe received 14 responses. Rarely have the responders agreed to the same practice in most of the questions. Different choices were given by responders with regards the indications for cell culture, techniques used, primary and secondary dressings used, first wound review timing, and measures used to evaluate outcomes. ConclusionIn the current economic environment, the NHS needs to rationalize services on the basis of cost effectiveness. CEA is an expensive procedure that requires an adequately sterile laboratory, special equipments and highly experienced dedicated staff. When dealing with expensive management options, it is important to have an agreed protocol that can form the standard that can be referred to when auditing practices and results to improve burn management and patients’ care.

Mepitel® One: a wound contact layer with Safetac® technology

This article examines the use of Mepitel One, a wound contact layer that promotes wound healing by using the clinical benefits of Safetac technology. A wide range of clinical evidence shows that dressings with Safetac prevent trauma, minimise wound pain and associated psychological stress, while facilitating undisturbed wound healing. Mepitel One has been developed as a highly transparent wound contact layer with Safetac on the wound contact surface alone; this makes it easy to apply without sticking to gloves, and allows it to be used with a choice of secondary dressings. The dressing can stay in place for up to 14 days and allows examination of the wound without removal. The clinical evidence reviewed here shows that Mepitel One is a versatile option for use on a wide range of wound types to promote undisturbed healing and minimise pain at dressing changes.

Prospective Randomized Controlled Trial

INTRODUCTION: Pain at split skin graft donor sites is common. Fibrin sealant has been demonstrated to reduce time to hemostasis at wound sites, and patients receiving this treatment were noted to report less pain, triggering this study, which aimed to evaluate pain and incapacity with and without fibrin sealant. METHODS: Fifty patients requiring split skin grafts were prospectively randomized to receive either Mefix only (Mölnlycke Health Care Ltd), or the fibrin sealant TISSEEL (Baxter Healthcare Ltd) plus Mefix, as primary donor site dressings. External secondary dressings were the same. Patients were blinded with regard to treatment group. Using visual analogue scales (scored 0-5), patients were asked to rate their donor site pain and incapacity for 14 days post-operatively. Secondary endpoints were length of hospital stay and duration of requirement for dressings. RESULTS: Fifty patients were recruited and 43 (86.0%) completed self-reported pain and incapacity scores. Twenty-two received TISSEEL plus Mefix and twenty-one received Mefix only (controls). Patients using TISSEEL plus Mefix reported significantly less pain (mean score 0.41 vs. 1.46, p<0.001), and significantly less incapacity (mean score 0.44 vs. 1.54, p<0.001). Patients allocated to the TISSEEL group recorded shorter lengths of stay and faster time to discontinuation of dressing, though statistical significance was not achieved. CONCLUSION: Patients whose split skin graft donor sites were dressed with TISSEEL plus Mefix experienced significantly less pain and incapacity than patients with Mefix dressings. This resulted in a shorter inpatient stay for patients treated with TISSEEL.Figure 1: Mean Daily Post Operative Pain Score, with 95% Confidence Intervals.Table 1: Table 1.

Randomised, controlled pilot to compare collagen and foam in stagnating pressure ulcers

To compare the clinical efficacy of a collagen dressing covered with a foam dressing with the same foam used as a primary dressing in stagnating granulating pressure ulcer patients. Patients were randomised to receive either a foam dressing (Suprasorb P; Lohmann & Rauscher) as a primary dressing (group A), or a combination of a collagen dressing (Suprasorb C; Lohmann & Rauscher) covered with the same foam dressing (group B).Wound fluid was collected and evaluated prior to treatment (day 0), and on days 3,7, 14 and 21 .The level and expression of matrix metalloproteinases (MMPs) MMP-2 and MMP-9, and tissue inhibitors of metalloproteinases (TIMPs) TIMP- I and TIMP-2,as well as elastase content in wound fluid and angiogenesis,were evaluated, comparing results on day 0 and day 2 I.Time to ulcer healing, reduction in ulcer area, safety of treatment, patient-reported ulcer pain and comfort of the dressing regimen were evaluated as secondary outcomes. Patients received standard preventive measures, in line with the pressure ulcer prevention guidelines. Ten patients were included in the pilot; five were treated with the foam dressing (group A) and five patients received the collagen dressing, using the foam as a secondary dressing (group B).Wound fluid from group B displayed a significant positive effect on angiogenesis (p < 0.05) compared with group A. In the collagen and foam groupTIMP- I and -2 increased faster and levels were higher than in group A. Furthermore, MMP-2, MMP-9 (p < 0.04) and elastase in group B showed faster and greater decrease in levels, compared with group A, indicating a faster and superior reduction of inflammation. In both groups the ulcers started to heal, with a faster onset of healing for group B. The results of this pilot support published data on the use of collagen dressings compared with foam for stagnating wounds, shown in clinical studies. This study was supported with an educational grant by Lohmann & Rauscher GmbH.Apart from DrAbel, the sponsors had no role in the design or conduct of the study, in the collection, analysis and interpretation of the data, or in the preparation, review or approval of the manuscript. DrAbel gave input to the study design from a scientific perspective. None of the authors received administrative, technical or material support for the conduct of this study.The authors have no other relevant financial interests to declare.

A budget impact analysis comparing a Hydrofiber®; dressing to an alginate dressing in managing exuding venous leg ulcers in France

An Excel model was developed to compare total costs (including primary and secondary dressings only) of Hydrofiber(®) ; dressing (2010 branded price) versus an alginate dressing (generic or branded price) in managing exuding venous leg ulcers considering mean wear time and mean duration of exudate management phase, from the French Social Security perspective over 5 years (2011-2015). Budget impact (based on prevalence of venous leg ulcers in France) was estimated as the difference between scenario 1 (Hydrofiber(®) ; versus alginate dressing usage proportion increasing slightly per year) and Scenario2 (proportion remaining at 2010 levels). Annual costs and net savings per patient for the dressings were calculated in analyses 1 and 2. Analysis 1 (28-day mean exudate management phase for both Hydrofiber(®) ; and alginate dressing groups): total costs 66·82€ Hydrofiber(®) ;, 70·08€ generic alginate, 77·0€ branded alginate; net savings 3·26€ and 10·18€ for Hydrofiber(®) ; versus generic and branded alginate. Analysis 2 (mean exudate management phase of 22·2 versus 28 days for Hydrofiber(®) ; versus alginate): total costs 52·92€, 70·08€ and 77·0€, and net savings 17·10€ and 24·02€, accordingly. Total cost savings (budget impact scenario 1 minus scenario 2): Analysis 1 - 223 107€ and 696 304€ for Hydrofiber(®) ; versus generic and branded alginate dressings, respectively; Analysis 2 - 1 169 845€ and 1 643 042€ accordingly. Sensitivity analyses indicated that results are reliable. This conservative analysis shows that effective exudate management using Hydrofiber(®) ; dressing can produce sizeable cost savings.

Equine Pericardium as a Biological Covering for the Treatment of Diabetic Foot Wounds

Diabetic foot wounds remain a significant health-care issue. Healing these wounds in a timely manner is of paramount importance because the duration of ulceration correlates with increased rates of infection and amputation, costing billions of dollars yearly. Collagen-based matrices have been used as wound covers and have been shown to improve and expedite healing. We present our experience with equine pericardium biomatrix for the treatment of neuropathic foot wounds. Thirty-four patients with 37 diabetic foot wounds were evaluated at two institutions prospectively. All of the wounds were debrided, and equine pericardium biomatrix was applied. Secondary dressings were changed every 48 to 72 hours until healed or for 12 weeks after application. Healing rate at 12 weeks, time to wound closure, and complications were evaluated. Twenty-two men and 12 women (mean age, 56.9 years) were treated and evaluated. Mean and median wound sizes at initial treatment were 715.8 and 440 mm(2), respectively. The overall wound healing rate by 12 weeks was 75.7% (n =28). Mean and median times to wound closure were 7.2 and 7.0 weeks, respectively. No device or procedure-related complications were reported. The use of equine pericardium as a temporary biological scaffold is safe and effective for the treatment of chronic neuropathic foot wounds.

Prospective Cohort Study on Surgical Wounds Comparing a Polyhexanide-Containing Biocellulose Dressing with a Dialkyl-Carbamoyl-Chloride–Containing Hydrophobic Dressing

Postsurgery dressing changes in diabetic foot amputation wounds and surgical wounds healing by secondary intention are often conducted in the operating room under general anesthesia. A prospective comparative cohort study was performed in 60 patients (n = 60: n = 30/n = 30) with secondary-intention surgical wounds (82% had forefoot and/or digit[s] amputations) to compare 2 different dressing types. Patients at the study center gave informed written consent, after which they were randomly allocated to one of the treatment groups. Group A received a biocellulose dressing with polyhexanide, and group B a hydrophobic dressing with dialkyl-carbamoyl-chloride. In both groups, gauze was used as secondary dressing and fixed with a film dressing. One day after surgery, the dressings were removed by the surgeon and patient-reported pain and dressing adherence/integrity were evaluated. The number of patients that required general anesthesia was determined during the procedure and afterward. All patients (n = 60; n = 30/n = 30) were included in the intention-to-treat analysis. Pain levels in group A were significantly (t (59) = 4.026, P < .000) lower upon dressing removal, when compared with group B; in group A, n = 21 reported no pain versus n = 8 (26%) for group B. In group A, the dressing adhered in 7 subjects (23%) versus n = 27 (90%) of cases in group B (P = .000). No anesthesia was required for the patients in group A, contrary to group B, where 16% of patients received general anesthesia for dressing removal. Pain levels were significantly lower and the dressing adhered significantly less in group A, compared with group B, demonstrating a better quality of life for the patients in group A.

Superabsorbent dressings for copiously exuding wounds

Exudate control is important in the management of both acute and chronic wounds. A new category of absorbent dressings that contain superabsorbent particles promises high absorbency. The aim of this multicentre, prospective, non-comparative observational study was to evaluate the clinical efficacy and absorbent capacity of a superabsorbent dressing. Fifteen inpatients and outpatients with highly exuding wounds were included. Most patients (n=8) (53%) had chronic wounds; 20% (n=3) had ulcerating tumours. The superabsorbent dressing was used as a primary or a secondary dressing. Assessment was on day 0 (start), day 3 and day 7 (end of study). The study looked at wound bed and periwound skin condition, exudate production, pain upon dressing removal, reason for dressing removal, and frequency of dressing changes. A clinical visual scoring tool was used, together with digital photographs, which were assessed by the same experienced clinician. All 15 patients completed the study, during which no adverse events were noted. At day 7, maceration had reduced from 46.7% (n=7) at day 0 to 6.7% (n=1). After only 3 days, dressing change frequency was reduced from once daily to twice weekly in 80% (n=12) of patients. The superabsorbent dressing seems to reduce complications associated with exudate production, stimulate wound healing and increase patient comfort; it may also save time and costs for caregivers.

PolyMem®Wic®Silver®Rope: A Multifunctional Dressing for Decreasing Pain, Swelling, and Inflammation

Choosing the most appropriate dressing to meet the complex needs of patients with narrow deep wounds, such as tunnels, fistulas, and cysts, is a daunting task. Such wounds are difficult to cleanse and tend to be extremely painful. Wound patients need a drug-free dressing that handles exudates, decreases the need for traumatic cleansing during dressing changes, and addresses wound pain, inflammation, and swelling. Multifunctional PolyMem® dressings (the generic name is polymeric membrane dressings) contain ingredients that work synergistically to continuously cleanse wounds and bring about rapid healing. Nonadherent PolyMem provides atraumatic dressing changes. PolyMem also decreases persistent wound pain. PolyMem Silver provides effective antimicrobial action without destructive silver toxicity. PolyMem Wic® Silver® Rope is a new strong, but exceedingly supple, dressing comprised of PolyMem Wic Silver reinforced with embedded surgical mesh. Insertion and removal is so simple that patients often change their dressings themselves. The unique features of PolyMem combine to make the nonadherent dressings not only extremely comfortable, but also anti-inflammatory, thus addressing both persistent and procedural wound pain. PolyMem Wic Silver Rope is especially appropriate for deep wounds with narrow openings, such as tunnels, fistulas, and cysts, but it can be used in any acute or chronic wound, even in the presence of infection. PolyMem dressings enhance autolytic debridement, which often results in production of large quantities of pale yellow enzyme- and nutrient-rich wound fluid during the first treatment week. Extra-absorbent PolyMem Max secondary dressings can contain excess fluid.

Use of a keratin-based hydrogel in the management of recessive dystrophic epidermolysis bullosa

A new keratin-based hydrogel wound dressing was applied to the neck of a patient who was suffering from recessive dystrophic epidermolysis bullosa. A significant improvement was observed in the robustness of skin in this area: reduced propensity to blister and improved healing of blisters. The improvement allowed the cessation of use of secondary dressings for this area. The factors gave a significant improvement in quality of life for the patient.

An open label non-comparative case series on the efficacy of an enzyme alginogel

To evaluate the efficacy of an enzyme alginogel in outpatients with chronic or acute wounds left to heal by secondary intention. This evaluation was a single-centre, single-arm, case series involving 23 patients with wounds of diverse aetiologies treated with the enzyme alginogel (Flaminal; Flen Pharma). The product was applied in accordance with the manufacturer's instructions and wounds were covered with secondary dressings. Treatment was based on a scheduled protocol and patients were assessed at days 14, 30 and 60. Median baseline dimensions for the wounds were surface area 2.6cm2 and volume 2.8cm3. Median wound duration before application of the enzyme alginogel was 292 days, with 16 chronic wounds (78%). Three wounds were clinically infected at baseline; two were negative by day 14 and the third by day 30. After 2 months, wound surface area and volume had decreased, as could be expected. Two adverse events were reported: an allergic reaction in the skin surrounding the wound and transient maceration. The enzyme alginogel facilitated healing in chronic and acute wounds of diverse aetiologies. Additional research is warranted to confirm the clinical utility of the dressings in the management of chronic or acute wounds left to heal by secondary intention.

The Ideal Split-Thickness Skin Graft Donor Site Dressing

The almost single disadvantage of polyurethane film dressings, an uncontrolled leakage, is probably as often described as its numerous advantages for split-thickness skin graft donor sites. We solved this problem by perforating the polyurethane film, which permits a controlled leakage into a secondary absorbent dressing. The study included 30 adult patients. Skin graft donor sites at the proximal thigh were dressed with the modified film dressing. Our results indicate that this dressing concept is associated with a reliable, rapid rate of epithelization. Both, controlled leakage and minimal pain caused particular comfort for patients and ward staff. Furthermore, this dressing was also suited for differently shaped and large donor sites. We conclude that the modification results in a more practicable, comfortable, and cost-effective film dressing, which requalifies the polyurethane film as an ideal dressing material for split-thickness skin graft donor sites.

The use of Urgotul™ in the treatment of partial thickness burns and split‐thickness skin graft donor sites: a prospective control study

The use of paraffin-impregnated gauze for burns and skin graft donor sites is commonly associated with wound adherence with consequent pain and trauma upon removal. This prospective clinical study was performed to evaluate a new class of lipido-colloid dressings (Urgotul) in promoting healing and in reducing tissue adherence. In a 6-month period, 25 consecutive patients were recruited. Two separate burn or donor sites on each patient were dressed with tulle-gras (TG) or Urgotul and covered with standard secondary dressings. Objective assessment of wounds by two reviewers, and patients' subjective assessments were recorded. Twenty-three (92%) patients were followed up for a mean of 3 months. Mean time to complete epithelialisation was 9.6 and 11.9 days for the Urgotul and TG sites respectively (P < 0.05). Bleeding was seen in 52% of Urgotul sites compared with 100% of the TG sites at first dressing change (P < 0.05). Patients reported 'moderate pain' during dressing change in 22% and 57% in the Urgotul and TG groups respectively (P < 0.05), with 35% of TG sites being 'very painful' requiring extra analgesia. We found that compared with TG, Urgotul was associated with faster epithelialisation, less pain and trauma (bleeding) during dressing changes.

Wound-Product Selection and Innovations

Clinical Issue—Sharp debridement may not be an option for patients presenting with unstageable wounds and the impending loss of a pharmaceutical debrider served as a mobilizing factor in our quest to find a viable alternative to surgical and enzymatic debridement. OBJECTIVE: We began to examine choices in the marketplace that would allow debridement choices for those patients who would not be considered surgical candidates. Whirlpool tubs had been removed from our hospital and the remaining enzymatic debrider was not offering us the results we sought. Honey was reported in the literature as a potential debriding alternative and was chosen to see if the debriding activity would provide the results we desired in a wound—a clean granular tissue base. METHODS: Selection criteria were fairly straightforward. We selected patients who were not surgical candidates, had pressure ulcers that had not responded to an enzymatic debrider, and had the approval of physician, patient or healthcare proxy. Patients and family members were overall quite agreeable as this product would not cause pain or bleeding as would be experienced with surgical or enzymatic debriders. The honey dressings were applied either on top of or placed into a wound over nonviable tissue. Absorbent dressings served as secondary dressings and wounds were changed every other day until drainage necessitated daily dressing changes. Wound photography was obtained at the beginning of the study and on a weekly basis until treatment with the honey dressing was discontinued. RESULTS: Patients reported no pain with this product and in each patient, the wounds showed improvement by the second or third dressing change. Improvement was noted to be increasing amount of fresh viable tissue with a decreasing percentage of nonviable tissue present in the wound. Nursing staff reported that the product was easy to use and apply.

Use of Biatain dressing material in patients with diabetic foot syndrome: randomized comparative study

Aim. To compare efficiency, safety, and cost of different treatment modalities. Materials and methods. The study included 40 patients with type 1 and 2 diabetes, foot and lower leg trophic ulcers at granulation stage I-II (Wagners classification)free from wound infection. The patients were randomized for the treatment during 2 months with a Biatain dressing (Coloplast, Denmark)(group1) and for conventional treatment with the use of an atraumatic mesh dressing (group 2). Biatain dressings were changed every 2-4 (up to 5) daysand conventional dressings once daily. Patients in the two groups were adjusted for age, sex, ulcer type, size and duration, length of antibiotic therapy beforeand during treatment, blood glucose level, and other characteristics (p&gt;0.05). Results. Ulcers healed within 2 months in 70% of the patients in group 1 and in 53.3% in group 2 (insignificant difference, p = 0.48). Other efficiency (medianhealing time, survival curves) and safety parameters were not significantly different either. The cost of treatment by the two methods was comparabledespite a higher cost of Biatain dressings due to their rarer change and economy of material for secondary dressing. When dressings were changed by medicalprofessionals rather than by the patient or his (her) relatives at home, treatment with the use of Biatain dressings proved 1.75 times cheaper. Conclusion. Efficiency and safety of high-tech and conventional dressing materials is comparable. The real difference between the costs of treatment byeither method is significantly smaller than the difference between retail prices of the two materials. Cost effectiveness of high-tech dressings is higher if thetreatment is accomplished in a medical facility.