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Cost analysis of negative-pressure wound therapy with instillation for wound bed preparation preceding split-thickness skin grafts for massive (>100 cm(2)) chronic venous leg ulcers.
- Source :
-
Journal of vascular surgery [J Vasc Surg] 2015 Apr; Vol. 61 (4), pp. 995-9. Date of Electronic Publication: 2015 Jan 13. - Publication Year :
- 2015
-
Abstract
- Objective: Massive (≥100 cm(2)) venous leg ulcers (VLUs) demonstrate very low closure rates with standard compression therapy and are costly to manage. Negative-pressure wound therapy (NPWT), followed by a split-thickness skin graft (STSG), can be a cost-effective alternative to this standard care. We performed a cost analysis of these two treatments.<br />Methods: A retrospective review was performed of 10 ulcers treated with surgical debridement, 7 days of inpatient NPWT with topical antiseptic instillation (NPWTi), and STSG, with 4 additional days of inpatient NPWT bolster over the graft. Independent medical cost estimators were used to compare the cost of this treatment protocol with standard outpatient compression therapy.<br />Results: The average length of time ulcers were present before patients entered the study was 38 months (range, 3-120 months). Eight of 10 patients had complete VLU closure by 6 months after NPWTi with STSG. The 6-month costs of the proposed treatment protocol and standard twice-weekly compression therapy were estimated to be $27,000 and $28,000, respectively.<br />Conclusions: NPWTi with STSG treatment is more effective for closure of massive VLUs at 6 months than that reported for standard compression therapy. Further, the cost of the proposed treatment protocol is comparable with standard compression therapy.<br /> (Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Administration, Cutaneous
Aged
Anti-Infective Agents, Local administration & dosage
Anti-Infective Agents, Local economics
Chronic Disease
Combined Modality Therapy
Cost-Benefit Analysis
Debridement economics
Drug Costs
Female
Humans
Male
Middle Aged
Retrospective Studies
Time Factors
Treatment Outcome
Varicose Ulcer diagnosis
Varicose Ulcer physiopathology
Varicose Ulcer surgery
Wound Healing
Hospital Costs
Negative-Pressure Wound Therapy economics
Skin Transplantation economics
Therapeutic Irrigation economics
Varicose Ulcer economics
Varicose Ulcer therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6809
- Volume :
- 61
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of vascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 25595397
- Full Text :
- https://doi.org/10.1016/j.jvs.2014.11.076