An economic evaluation of the use of TNP on full-thickness wounds

Abstract

Topical negative pressure (TNP) (vacuum therapy) is frequently used in the management of acute, traumatic, infected and chronic full-thickness wounds. This prospective clinical randomised trial compared the costs of TNP with conventional therapy (moist gauze) in the management of full-thickness wounds that required surgical closure. The direct medical costs of the total number of resources needed to achieve a healthy, granulating wound bed that was 'ready for surgical therapy' were calculated. Fifty-four patients admitted to a department of plastic and reconstructive surgery were recruited into the trial. Cost analysis showed significantly higher mean material expenses for wounds treated with TNP (414euros+/-229euros [SD]) compared with conventional therapy (15euros+/-11euros; p<0.0001 ), but significantly lower mean nursing expenses (33euros+/-31 euros and 83euros+/-58euros forTNP and conventional therapy respectively; p<0.0001). Hospitalisation costs were lower in theTNP group (1788euros+/-1060euros) than in the conventional treatment group (2467euros+/-1336euros; p<0.043) due to an on average shorter duration until they were'ready for surgical therapy'. There was no significant difference in total costs per patient between the two therapies (2235euros+/-1301euros for TNP versus 2565euros+/-1384euros for conventional therapy). TNP had higher material costs. However, these were compensated by the lower number of time-consuming dressing changes and the shorter duration until they were 'ready for surgical therapy', resulting in the therapy being equally as expensive as conventional moist gauze. This work was partly supported by the Plastic and Reconstructive Surgery Esser Foundation, and KCI Medical, Houten,The Netherlands. The authors have no conflicts of interest.