M Jenda Hop1, Monica C T Bloemen2, Margriet E van Baar3, Marianne K Nieuwenhuis4, Paul P M van Zuijlen5, Suzanne Polinder6, Esther Middelkoop7. 1. Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 2. Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands. 3. Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands. Electronic address: baarm@maasstadziekenhuis.nl. 4. Association of Dutch Burn Centres, Martini Hospital, Groningen, The Netherlands. 5. Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands; Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands. 6. Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands. 7. Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands; Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands.
Abstract
BACKGROUND: A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment. METHODS: The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity. RESULTS: Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP (p=0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 (p<0.001). However, mean total costs per patient did not differ significantly between groups (range €29097-€43774). DISCUSSION: Costs of the interventional treatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role.
BACKGROUND: A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment. METHODS: The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity. RESULTS: Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP (p=0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 (p<0.001). However, mean total costs per patient did not differ significantly between groups (range €29097-€43774). DISCUSSION: Costs of the interventional treatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role.
Authors: Zjir M Rashaan; Pieta Krijnen; Kelly Aa Kwa; Margriet E van Baar; Roelf S Breederveld; M Elske van den Akker-van Marle Journal: Wound Repair Regen Date: 2020-02-11 Impact factor: 3.617
Authors: Yvonne Zens; Michael Barth; Heiner C Bucher; Katrin Dreck; Moritz Felsch; Wolfram Groß; Thomas Jaschinski; Heike Kölsch; Mandy Kromp; Inga Overesch; Stefan Sauerland; Sven Gregor Journal: Syst Rev Date: 2020-10-10