Cost-effective Alternative for Negative-pressure Wound Therapy

Abstract

Background:Current predominantly used equipments for negative-pressure wound therapy (NPWT) are expensive. In current healthcare climate continually emphasizing cost containment, importance in developing more cost-effective alternatives cannot be understated. Previously, therapeutically equivalent methods of providing NPWT was demonstrated using just low-cost, universally available supplies, coined Gauze-SUCtion (GSUC). Here, we examine long-term potential financial savings of utilizing GSUC over commercialized products.Methods:A retrospective cost analysis was performed at the University of Chicago Medical Center between 1999 and 2014. All NPWT was provided via either GSUC or commercialized vacuum-assisted closure (VAC, KCI) device. Sum of all material component costs were reviewed to determine theoretical average daily cost. For the VAC group, recorded institutional spend to KCI was also reviewed to determine actual daily cost. In the GSUC group, this figure was extrapolated using similar ratios. Labor costs for each method were determined using analysis from prior study. Patient demographics, etiology, wound location, and treatment length were also reviewed.Results:Total of 35,871 days of NPWT was provided during the 15-year span. Theoretical average cost of VAC was $94.01/d versus $3.61/d for GSUC, whereas actual average was $111.18/d versus $4.26/d. Average labor cost was $20.11/dressing change versus $12.32. Combined, total cost of VAC therapy was estimated at $119,224 per every 1,000 days of therapy versus $9,188 for the GSUC.Conclusions:There is clear and significant cost savings from utilization of GSUC method of NPWT. Furthermore, the added advantage of being able to provide NPWT from universally accessible materials cannot be overstated.

Fluorescence imaging guided dressing change frequency during negative pressure wound therapy: a case series

“…14 In contrast, in the current study it took less than one minute to image the wound through the adhesive dressing to determine if a dressing change should be expedited or delayed. The average cost of NPWT supplies per dressing change was reported as $69 USD in a 2017 retrospective review of >35,000 total days of NPWT occurring over 15 years, 15 for a total cost of $89 USD per dressing change. NPWT dressing changes were performed every 2-3 days in these studies, as per manufacturer guidelines.…”

“…• NPWTi is the more novel therapy, therefore evidence is continuously evolving as large clinical studies and retrospective reviews enter the literature 1,9,13 • Monitoring of bioburden status via sampling or via clinical signs and symptoms requires removal of the adhesive and NPWT foam, i.e a complete dressing change, which is costly in terms of both materials and clinician time 14,15 • Wound sampling is further associated with delays while awaiting microbiological results.…”

Results of directly applied activated carbon cloth in chronic wounds: a preliminary study

“…The main disadvantages of NPWT are that it is time-consuming with complex dressing changes and at a the substantially higher price. 26 ACC dressings can absorb fluids and antimicrobial properties, 6 is less time-consuming compared with NPWT and is changed in intervals of usually 3-5 days, but can be left up to seven days on the wound. 6,27 Furthermore, dressings must not necessarily be done by a wound specialist.…”

Application of Negative Pressure Wound Therapy on Closed Incisions

“…An estimated cost of $100 per day was associated with the use of the PREVENA (V.A.C therapy, KCI, San Antonio, TX) system, which showed significant reduction in SSI risk [27]. With a typical use of 5-7 days, cost of ciNPWT is estimated around $500-700.…”