An Economic Analysis of a Single-Use Negative Pressure Wound Therapy (sNPWT) Device Compared to Conventional Dressings in Reducing Surgical Site Complications Following Surgery

Background: Surgical site complications (SSCs) are associated with excess morbidity and mortality and represent a significant burden to the health-care system, making surgical site infection (SSI) prevention an important perioperative care objective. Our study assessed the cost-effectiveness of sNPWT* compared to standard post-surgical dressings (standard care) in reducing SSCs following surgery.

Methods: An economic model was developed to explore the total costs and health outcomes associated with the use of sNPWT and standard care in patients following vascular, colorectal, cardiothoracic, orthopaedic, C-section, and breast surgery from the U.S. payer’s perspective over a 12-week time horizon. We modeled complications avoided (SSI and dehiscence) both inpatient and outpatient. We performed a meta-analysis of published sNPWT studies across surgical specialities for clinical inputs. Cost data were sourced from published literature and Centers for Medicare & Medicaid Services. We conducted sub-groups analysis of patients with diabetes, American Society of Anesthesiologists (ASA) score ≥3, Body Mass Index (BMI) ≥30, and sensitivity analysis.

Results:

 Outcome                                                           sNPWT            Standard Care             Difference

 Number of SSIs per 1,000                               20                    51                                -31

 Number of dehisced wounds per 1,000           52                   69                                -17

 Total cost per patient                                      $819                $1,107                         -$288

sNPWT resulted in better clinical outcomes and overall savings of $288 per patient. There were more savings when higher risk patients with diabetes, BMI≥30, and ASA≥3 were considered.

Conclusion: Our findings suggest that the use of sNPWT following surgery is a good use of scarce resources when compared to standard care, as it results in reduced incidence of SSC and LOS. This analysis is underpinned by strong and robust clinical evidence from both randomized and observational evidence.