Cost-effectiveness analysis of single use negative pressure wound therapy dressings (sNPWT) compared to standard of care in reducing surgical site complications (SSC) in patients undergoing coronary artery bypass grafting surgery

• DOI: 10.1186/s13019-018-0786-6
• Publication Date: 2018-10-03T09:49:20Z
• Authors: Leo M Nherera; Paul Trueman; Michael Schmoeckel; Francis A Fatoye
• Keywords: Male; Reoperation; RD1-811; Cost-Benefit Analysis; Surgical site complications; Patient Readmission; Single use negative pressure wound therapy; cost-effectiveness; 03 medical and health sciences; 0302 clinical medicine; Anesthesiology; Germany; Humans; Surgical Wound Infection; RD78.3-87.3; Prospective Studies; Coronary Artery Bypass; CABG; Standard of Care; Length of Stay; Middle Aged; Bandages; 3. Good health; Surgery; Female; Poland; Quality-Adjusted Life Years; Negative-Pressure Wound Therapy; Research Article

There is a growing interest in using negative pressure wound therapy in closed surgical incision to prevent wound complications which continue to persist following surgery despite advances in infection measures.To estimate the cost-effectiveness of single use negative pressure wound therapy (sNPWT) compared to standard of care in patients following coronary artery bypass grafting surgery (CABG) procedure to reduce surgical site complications (SSC) defined as dehiscence and sternotomy infections.A decision analytic model was developed from the Germany Statutory Health Insurance payer's perspective over a 12-week time horizon. Baseline data on SSC, revision operations, length of stay, and readmissions were obtained from a prospective observational study of 2621 CABG patients in Germany. Effectiveness data for sNPWT was taken from a randomised open label trial conducted in Poland which randomised 80 patients to treatment with either sNPWT or standard care. Cost data (in Euros) were taken from the relevant diagnostic related groups and published literature.The clinical study reported an increase in wounds that healed without complications 37/40 (92.5%) in the sNPWT compared to 30/40 (75%) patients in the SC group p = 0.03. The model estimated sNPWT resulted in 0.989 complications avoided compared to 0.952 and the estimated quality adjusted life years were 0.8904 and 0.8593 per patient compared to standard care. The estimated mean cost per patient was €19,986 for sNPWT compared to €20,572 for SC resulting in cost-saving of €586. The findings were robust to a range of sensitivity analyses.The sNPWT can be considered a cost saving intervention that reduces surgical site complications following CABG surgery compared to standard care. We however recommend that additional economic studies should be conducted as new evidence on the use of sNPWT in CABG patients becomes available to validate the results of this economic analysis.