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Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds.

Apelqvist, Jan LU ; Armstrong, David G; Lavery, Lawrence A and Boulton, Andrew J M (2008) In American Journal of Surgery 195. p.782-788
Abstract
BACKGROUND: To evaluate resource utilization and direct economic costs of care for patients treated with negative-pressure wound therapy (NPWT), using the Vacuum-Assisted Closure (V.A.C.) system, compared to standard moist wound therapy (MWT). METHODS: A total of 162 diabetic patients with post-amputation wounds (up to the trans-metatarsal level) entered a 16-week, randomized clinical trial. Patients randomized to V.A.C. (n = 77) received therapy with dressing changes every 48 hours. Control patients (n = 85) received standard MWT. Resource utilization, procedures, and direct costs were calculated and analyzed in this post hoc retrospective study. RESULTS: There was no difference between groups for in-patient hospital stay (number of... (More)
BACKGROUND: To evaluate resource utilization and direct economic costs of care for patients treated with negative-pressure wound therapy (NPWT), using the Vacuum-Assisted Closure (V.A.C.) system, compared to standard moist wound therapy (MWT). METHODS: A total of 162 diabetic patients with post-amputation wounds (up to the trans-metatarsal level) entered a 16-week, randomized clinical trial. Patients randomized to V.A.C. (n = 77) received therapy with dressing changes every 48 hours. Control patients (n = 85) received standard MWT. Resource utilization, procedures, and direct costs were calculated and analyzed in this post hoc retrospective study. RESULTS: There was no difference between groups for in-patient hospital stay (number of admissions or length of stay). More surgical procedures (including debridement) were required in the MWT group (120 vs 43 NPWT, P <.001). The average number of dressing changes performed per patient was 118.0 (range 12-226) for MWT versus 41 (6-140) for NPWT (P = .0001). The MWT group had 11 (range 0-106) outpatient treatment visits during the study versus 4 (range 0-47) in the NPWT group (P <.05). The average direct cost per patient treated for 8 weeks or longer (independent of clinical outcome) was $27,270 and $36,096 in the NPWT and MWT groups, respectively. The average total cost to achieve healing was $25,954 for patients treated with NPWT (n = 43) compared with $38,806 for the MWT group (n = 33). CONCLUSION: Treatment of diabetic patients with post amputation wounds using NPWT resulted in lower resource utilization and a greater proportion of patients obtaining wound healing at a lower overall cost of care when compared to MWT. (Less)
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author
organization
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type
Contribution to journal
publication status
published
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in
American Journal of Surgery
volume
195
pages
782 - 788
publisher
Elsevier
external identifiers
  • pmid:18355797
  • wos:000256585700010
  • scopus:44349193355
ISSN
1879-1883
DOI
10.1016/j.amjsurg.2007.06.023
language
English
LU publication?
yes
id
eb14c9e8-06a2-4600-bbb4-898e3287f172 (old id 1052274)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18355797?dopt=Abstract
date added to LUP
2008-04-01 08:45:05
date last changed
2017-08-06 04:48:33
@article{eb14c9e8-06a2-4600-bbb4-898e3287f172,
  abstract     = {BACKGROUND: To evaluate resource utilization and direct economic costs of care for patients treated with negative-pressure wound therapy (NPWT), using the Vacuum-Assisted Closure (V.A.C.) system, compared to standard moist wound therapy (MWT). METHODS: A total of 162 diabetic patients with post-amputation wounds (up to the trans-metatarsal level) entered a 16-week, randomized clinical trial. Patients randomized to V.A.C. (n = 77) received therapy with dressing changes every 48 hours. Control patients (n = 85) received standard MWT. Resource utilization, procedures, and direct costs were calculated and analyzed in this post hoc retrospective study. RESULTS: There was no difference between groups for in-patient hospital stay (number of admissions or length of stay). More surgical procedures (including debridement) were required in the MWT group (120 vs 43 NPWT, P &lt;.001). The average number of dressing changes performed per patient was 118.0 (range 12-226) for MWT versus 41 (6-140) for NPWT (P = .0001). The MWT group had 11 (range 0-106) outpatient treatment visits during the study versus 4 (range 0-47) in the NPWT group (P &lt;.05). The average direct cost per patient treated for 8 weeks or longer (independent of clinical outcome) was $27,270 and $36,096 in the NPWT and MWT groups, respectively. The average total cost to achieve healing was $25,954 for patients treated with NPWT (n = 43) compared with $38,806 for the MWT group (n = 33). CONCLUSION: Treatment of diabetic patients with post amputation wounds using NPWT resulted in lower resource utilization and a greater proportion of patients obtaining wound healing at a lower overall cost of care when compared to MWT.},
  author       = {Apelqvist, Jan and Armstrong, David G and Lavery, Lawrence A and Boulton, Andrew J M},
  issn         = {1879-1883},
  language     = {eng},
  pages        = {782--788},
  publisher    = {Elsevier},
  series       = {American Journal of Surgery},
  title        = {Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds.},
  url          = {http://dx.doi.org/10.1016/j.amjsurg.2007.06.023},
  volume       = {195},
  year         = {2008},
}