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CUH fracture clinic pins down savings

23 July 2015
The fracture clinic at Cambridge University Hospitals (CUH) is saving tens of thousands of pounds a year by using a better and cheaper type of dressing.

In the past both sponges and gauze have been used to dress the pin sites on a metal frame that has clamps and rods to immobilise the bones to allow a fracture to heal.

Sponges are more than twenty times as expensive as gauzes and also not as easy to keep clean, which is of vital importance to reduce the infection.

Now the clinic has standardised the procedure, saving money and ensuring patients are better protected from the risk of infection. On average the cost of dressing one patient for a year using gauze will make a saving of around £500.

Consultant orthopaedic surgeon Matija Krkovic Consultant orthopaedic surgeon Matija Krkovic explains: “If we treat the pin sites properly we don’t have to change the dressings as often and using gauze and Chlorhexidine is much better for patients.

“The sponges accumulate all the dirt from the discharge from the pin site and it can be literally bathing in all this excretion. 

“And the sponges don’t even look dirty for a long time and the patient will not feel an urge to change them. With the gauze, you put them on, they get dirty and you know when to change them. You are removing dirt each time when you clean it and it reduces the chance of infection. 

“Patients find it better with gauze and we can see now that sponges are much more expensive, so it was a no-brainer really.”

The metal frame, called an external fixator, is usually fitted for between six months and a year but in some cases it can be on for two years. In the first six weeks a pin site will need to be changed on average three times a week and less frequently after that.

An external fixatorIn the past, two methods were used to dress pin site wounds: sponges or gauze with Chlorhexidine, a synthetic compound used as a mild antiseptic. The Clinic has considerably reduced their spending by using gauze and Chlorhexidine at a cost of just 0.75p per patient, against the cost of £20.39 with sponges. CUH can fit between 10 to 15 external fixators in a month so the savings add up.

A large majority of those are passed on to Clinical Commissioning Groups (CCGs) when the patients need their dressings changed outside of fracture clinic. And it’s not just the Cambridgeshire area that benefits, as CUH is a major trauma centre which takes in patients from all over the country.