Background and Importance The pressure ulcer (PU), tissue lesion consequence of high or prolonged constant pressure over time, represents the third most costly disease for the health care system, causing over 60,000 deaths each year¹.

The use, during the Sars-Cov-2 pandemic, of the bacteria binding medication (BBM) to reduce PU, was the starting point that allowed the spread of BBM in many hospital departments, as a possible therapeutic alternative to iodoform gauze (IG). BBM, consisting of fabric saturated with dialkylcarbamoylchloride (DACC), is able to capture bacteria and fungi thanks to a physical mechanism (hydrophobic interaction) instead of IG that control the wound microenvironment in the short term with an high risk of possible toxicity due to the systemic absorption of iodine.

Aim and Objectives Considering the increased incidence of PU related to care services, the Hospital Pharmacy, assisted by wound care specialists (WCS), has monitored in the period from 2020 to 2023 the prescriptive appropriateness and the consumption of BBM in different departments in order to demonstrate the greater safety and effectiveness than the IG.

Material and Methods Since September 2020 the Hospital Pharmacy has selected some pilot wards in which a WCS operate, and subsequently equipped them with BBM. A cost-effectiveness analysis was conducted by comparing IG and BBM.

After reviewing the excellent performance of the device in the first selected departments, the Pharmacy, the clinicians and WCS have collaborated to identify in which clinical situations it was possible to replace IG with BBM and when to prefer other therapeutic choices.

Results The performed analysis showed that, in the single service, the cost of BBM is 3% higher than IG, but in prolonged treatment the use of BBM is advantageous. BBM, compared to IG, can be left in place for up to 7 days reducing care costs (MD and WCS service) and the frequency of wound manipulation, limiting clinical complications and eliminating the risk of systemic iodine absorption caused by the IG.

PUs require long-term treatment BBM represent a cost-effective alternative and the Pharmacy has decided to introduce definitively the BBM into the hospital formulary and to dismiss IG.

References and/or Acknowledgements 1. AfzaliBorojeny L, et al. Int J Prev Med. 2020 Oct 5;11:171.

Conflict of Interest No conflict of interest.