Negative pressure wound therapy with instillation, a cost-effective treatment for abdominal mesh exposure
- 194 Downloads
Negative pressure wound therapy with instillation (NPWTi) has been proved to be a safe and effective treatment option for abdominal wall wound dehiscence with mesh exposure. Our aim in this study is to examine whether it is also cost-effective.
We performed a retrospective cohort study with 45 patients treated for postoperative abdominal wall wound dehiscence and exposed mesh: 34 were treated with conventional wound therapy (CWT) and 11 with NPWTi. We carried out a cost analysis for each treatment group using the Diagnosis-related group (DRG) system and a second evaluation using the calculated costs “per hospital stay”. The differences between NPWTi and CWT were calculated with both evaluation systems. Comparative analysis was performed using the Mann–Whitney U test.
Mean costs using the DRG estimation were 29,613.71€ for the CWT group and 15,093.37€ for the NPWTi group, and according to the calculated expenses “per hospital stay”, 17,322.88€ for the CWT group and 15,284.22€ for the NPWTi group. NPWTi showed a reduction in the total expense of treatment, related to a reduction in episodes of hospitalization and number of surgeries required to achieve wound closure. However, differences were not statistically significant in our sample.
NPWTi proves to be an efficient treatment option for abdominal wall wound dehiscence with mesh exposure, compared to CWT. More trials aimed to optimize treatment protocols will lead to an additional increase in NPWTi efficiency. In addition, to generalize our results, further studies with larger samples would be necessary.
KeywordsAbdominal wall Diagnosis-related groups Efficiency Surgical mesh Vacuum-assisted closure
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval was agreed by the ethical committee of the institution.
Human and animal rights
The study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.
Informed consent was obtained from all individual participants included in the study.
- 7.van Ramshorst GH, Eker HH, van der Voet JA et al (2013) Long-term outcome study in patients with abdominal wound dehiscence: a comparative study on quality of life, body image, and incisional hernia. JOGS 17:1477–1484Google Scholar
- 9.Kim PJ, Attinger CE, Olawoye O et al (2015) Negative pressure wound therapy with instillation: review of evidence and recommendations. Wounds 27:S2–S19Google Scholar
- 12.BOCM-20130910-1. Orden por la que se fijan los precios públicos por la prestación de los servicios y actividades de naturaleza sanitaria de la Red de Centros de la Comunidad de Madrid. [Internet] Boletín Oficial de la Comunidad de Madrid. Madrid; 2013 [consulted in 12th January 2017]. http://www.madrid.org/wleg_pub/secure/normativas/contenidoNormativa.jsf
- 24.Banasiewicz T, Cybulka B, Iqbal A et al (2014) Clinical and economic benefit of negative pressure wound therapy in treatment of the open abdomen. NPWT 1:39–47Google Scholar