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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.

Authors :
Yang CK
Alcantara S
Goss S
Lantis JC 2nd
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.)

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