E Deleyto1, A García-Ruano2,3, J R González-López4. 1. Department of Plastic Surgery, Universitary Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007, Madrid, Spain. 2. Department of Plastic Surgery, Universitary Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007, Madrid, Spain. dra.angelagr@gmail.com. 3. , C/Gustavo Bacarisas 2, 6°B, 41010, Seville, Spain. dra.angelagr@gmail.com. 4. Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, C/ Avenzoar, nº 6, 41009, Seville, Spain.
Abstract
PURPOSE: Negative pressure wound therapy with instillation (NPWTi) has been proved to be a safe and effective treatment option for abdominal wall wound dehiscence with mesh exposure. Our aim in this study is to examine whether it is also cost-effective. METHODS: We performed a retrospective cohort study with 45 patients treated for postoperative abdominal wall wound dehiscence and exposed mesh: 34 were treated with conventional wound therapy (CWT) and 11 with NPWTi. We carried out a cost analysis for each treatment group using the Diagnosis-related group (DRG) system and a second evaluation using the calculated costs "per hospital stay". The differences between NPWTi and CWT were calculated with both evaluation systems. Comparative analysis was performed using the Mann-Whitney U test. RESULTS: Mean costs using the DRG estimation were 29,613.71€ for the CWT group and 15,093.37€ for the NPWTi group, and according to the calculated expenses "per hospital stay", 17,322.88€ for the CWT group and 15,284.22€ for the NPWTi group. NPWTi showed a reduction in the total expense of treatment, related to a reduction in episodes of hospitalization and number of surgeries required to achieve wound closure. However, differences were not statistically significant in our sample. CONCLUSIONS: NPWTi proves to be an efficient treatment option for abdominal wall wound dehiscence with mesh exposure, compared to CWT. More trials aimed to optimize treatment protocols will lead to an additional increase in NPWTi efficiency. In addition, to generalize our results, further studies with larger samples would be necessary.
PURPOSE: Negative pressure wound therapy with instillation (NPWTi) has been proved to be a safe and effective treatment option for abdominal wall wound dehiscence with mesh exposure. Our aim in this study is to examine whether it is also cost-effective. METHODS: We performed a retrospective cohort study with 45 patients treated for postoperative abdominal wall wound dehiscence and exposed mesh: 34 were treated with conventional wound therapy (CWT) and 11 with NPWTi. We carried out a cost analysis for each treatment group using the Diagnosis-related group (DRG) system and a second evaluation using the calculated costs "per hospital stay". The differences between NPWTi and CWT were calculated with both evaluation systems. Comparative analysis was performed using the Mann-Whitney U test. RESULTS: Mean costs using the DRG estimation were 29,613.71€ for the CWT group and 15,093.37€ for the NPWTi group, and according to the calculated expenses "per hospital stay", 17,322.88€ for the CWT group and 15,284.22€ for the NPWTi group. NPWTi showed a reduction in the total expense of treatment, related to a reduction in episodes of hospitalization and number of surgeries required to achieve wound closure. However, differences were not statistically significant in our sample. CONCLUSIONS: NPWTi proves to be an efficient treatment option for abdominal wall wound dehiscence with mesh exposure, compared to CWT. More trials aimed to optimize treatment protocols will lead to an additional increase in NPWTi efficiency. In addition, to generalize our results, further studies with larger samples would be necessary.
Authors: Gabrielle H van Ramshorst; Hasan H Eker; Jan A van der Voet; Johannes Jeekel; Johan F Lange Journal: J Gastrointest Surg Date: 2013-05-29 Impact factor: 3.452
Authors: Ingo Ludolph; Frederik W Fried; Katharina Kneppe; Andreas Arkudas; Marweh Schmitz; Raymund E Horch Journal: Int Wound J Date: 2018-07-04 Impact factor: 3.315
Authors: Paul J Kim; Christopher E Attinger; Thomas Constantine; Brett D Crist; Elizabeth Faust; Christoph R Hirche; Lawrence A Lavery; Valerie J Messina; Norihiko Ohura; Laurie J Punch; Garrett A Wirth; Ibby Younis; Luc Téot Journal: Int Wound J Date: 2019-10-30 Impact factor: 3.315