OBJECTIVE:Topical negative pressure (TNP) (vacuum therapy) is frequently used in the management of acute, traumatic, infected and chronic full-thickness wounds. This prospective clinical randomised trial compared the costs of TNP with conventional therapy (moist gauze) in the management of full-thickness wounds that required surgical closure. METHOD: The direct medical costs of the total number of resources needed to achieve a healthy, granulating wound bed that was 'ready for surgical therapy' were calculated. RESULTS:Fifty-four patients admitted to a department of plastic and reconstructive surgery were recruited into the trial. Cost analysis showed significantly higher mean material expenses for wounds treated with TNP (414euros+/-229euros [SD]) compared with conventional therapy (15euros+/-11euros; p<0.0001 ), but significantly lower mean nursing expenses (33euros+/-31 euros and 83euros+/-58euros forTNP and conventional therapy respectively; p<0.0001). Hospitalisation costs were lower in theTNP group (1788euros+/-1060euros) than in the conventional treatment group (2467euros+/-1336euros; p<0.043) due to an on average shorter duration until they were'ready for surgical therapy'. There was no significant difference in total costs per patient between the two therapies (2235euros+/-1301euros for TNP versus 2565euros+/-1384euros for conventional therapy). CONCLUSION:TNP had higher material costs. However, these were compensated by the lower number of time-consuming dressing changes and the shorter duration until they were 'ready for surgical therapy', resulting in the therapy being equally as expensive as conventional moist gauze. DECLARATION OF INTEREST: This work was partly supported by the Plastic and Reconstructive Surgery Esser Foundation, and KCI Medical, Houten,The Netherlands. The authors have no conflicts of interest.
RCT Entities:
OBJECTIVE: Topical negative pressure (TNP) (vacuum therapy) is frequently used in the management of acute, traumatic, infected and chronic full-thickness wounds. This prospective clinical randomised trial compared the costs of TNP with conventional therapy (moist gauze) in the management of full-thickness wounds that required surgical closure. METHOD: The direct medical costs of the total number of resources needed to achieve a healthy, granulating wound bed that was 'ready for surgical therapy' were calculated. RESULTS: Fifty-four patients admitted to a department of plastic and reconstructive surgery were recruited into the trial. Cost analysis showed significantly higher mean material expenses for wounds treated with TNP (414euros+/-229euros [SD]) compared with conventional therapy (15euros+/-11euros; p<0.0001 ), but significantly lower mean nursing expenses (33euros+/-31 euros and 83euros+/-58euros forTNP and conventional therapy respectively; p<0.0001). Hospitalisation costs were lower in theTNP group (1788euros+/-1060euros) than in the conventional treatment group (2467euros+/-1336euros; p<0.043) due to an on average shorter duration until they were'ready for surgical therapy'. There was no significant difference in total costs per patient between the two therapies (2235euros+/-1301euros for TNP versus 2565euros+/-1384euros for conventional therapy). CONCLUSION: TNP had higher material costs. However, these were compensated by the lower number of time-consuming dressing changes and the shorter duration until they were 'ready for surgical therapy', resulting in the therapy being equally as expensive as conventional moist gauze. DECLARATION OF INTEREST: This work was partly supported by the Plastic and Reconstructive Surgery Esser Foundation, and KCI Medical, Houten,The Netherlands. The authors have no conflicts of interest.
Authors: Estas Bovill; Paul E Banwell; Luc Teot; Elof Eriksson; Colin Song; Jim Mahoney; Ronny Gustafsson; Raymund Horch; Anand Deva; Ian Whitworth Journal: Int Wound J Date: 2008-09-19 Impact factor: 3.315
Authors: Alastair J Richards; Sue M Hagelstein; Girish K Patel; Nicola M Ivins; Helen M Sweetland; Keith G Harding Journal: Int Wound J Date: 2011-08-31 Impact factor: 3.315