Cost-effectiveness of closed incison negative pressure wound therapy for reducing surgical site infections

Abstract

Objectives: Current preventive measures for the prevention of surgical site infections (SSI) are still not sufficient. We aimed to investigate the cost-effectiveness of negative pressure wound therapy (NPWT) on closed incisions in reducing SSI by reviewing local data or available data and values. Methods: We suggested a complication cost model for 100 patients, one-fourth of which were presumed as high-risk patients. In high-risk patients, the cost of negative pressure wound therapy (PrevenaTM) was added to the complication cost. The control group was another hypothetical group of patients, and the SSI cost was also calculated. The cost of negative pressure wound therapy (PrevenaTM) in this calculation was the actual raised price of the therapy system in Turkey in the beginning of 2019. Results: There was an additional 11.953 USD cost for the SSI in 100 amputation patients when standard care was performed. If we apply negative pressure wound therapy (PrevenaTM) in 25 patients who would be considered as high risk, the additional cost would be 11.361 USD. In the case of median sternotomy, the cost of SSI burden was 27.889 USD for standard care, and the cost burden including negative pressure wound therapy (PrevenaTM) cost for high-risk patients was calculated as 11.281 USD. In the laparotomy group, the cost burden of SSI in standard care was 165.105 USD, and negative pressure wound therapy (PrevenaTM) group had 96.767 USD. Conclusion: Applying negative pressure wound therapy (PrevenaTM) in high-risk patients, as recommended in World Health Organization guideline in different surgery types, demonstrates cost benefit. The cost benefit of PrevenaTM was more apparent in median sternotomy and laparotomy compared to amputation. Negative pressure wound therapy (PrevenaTM) can be a good choice in high-risk patients in cost perspective. Further studies would be needed to confirm the cost-effectiveness of negative pressure wound therapy (PrevenaTM) in different types of surgeries.