Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial

Author:

Älgå AndreasORCID,Löfgren Jenny,Haweizy Rawand,Bashaireh Khaldoon,Wong Sidney,Forsberg Birger C.,von Schreeb Johan,Malmstedt Jonas

Abstract

Abstract Background Clinical outcomes after negative-pressure wound therapy (NPWT) and standard treatment of conflict-related extremity wounds are similar. In resource-limited settings, cost affects the choice of treatment. We aimed to estimate treatment-related costs of NPWT in comparison with standard treatment for conflict-related extremity wounds. Methods We derived outcome data from a randomized, controlled superiority trial that enrolled adult (≥ 18 years) patients with acute (≤ 72 h) conflict-related extremity wounds at two civilian hospitals in Jordan and Iraq. Primary endpoint was mean treatment-related healthcare costs (adjusted to 2019 US dollars). Results Patients were enrolled from June 9, 2015, to October 24, 2018. A total of 165 patients (155 men [93.9%]; 10 women [6.1%]; and median [IQR] age, 28 [21–34] years) were included in the analysis. The cost per patient treated with NPWT was $142 above that of standard treatment. Overall, results were robust in a sensitivity analysis. Conclusions With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings. Trial registration NCT02444598.

Funder

Socialstyrelsen

Stockholms Läns Landsting

Médecins Sans Frontières

Karolinska Institute

Publisher

Springer Science and Business Media LLC

Subject

Emergency Medicine,Surgery

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