References

Jenks PJ, Laurent M, McQuarry S, Watkins R. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. J Hosp Infect. 2014; 86:(1)24-33 https://doi.org/10.1016/j.jhin.2013.09.012

Totty JP, Moss JWE, Barker E The impact of surgical site infection on hospitalisation, treatment costs, and health-related quality of life after vascular surgery. Int Wound J. 2021; 18:(3)261-268 https://doi.org/10.1111/iwj.13526

Shanmugam VK, Fernandez SJ, Evans KK Postoperative wound dehiscence: Predictors and associations. Wound Repair Regen. 2015; 23:(2)184-190 https://doi.org/10.1111/wrr.12268

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Single use negative pressure wound therapy in vascular patients: clinical and economic outcomes

02 September 2021
10 min read
Volume 5 · Issue 4

Abstract

Objective:

Surgical site complications (SSCs) such as dehiscence and infection are a common issue within vascular surgeries and are a key concern to payers and clinicians. It is estimated that occurrence of complications in vascular surgery can increment length of stay by 9.72 days and costs by £3776 per episode. The objective of this research was to determine the clinical and economic impact of the prophylactic use of single use negative pressure wound therapy (sNWPT) in postoperative femoral endarterectomy incisions within a single centre in the Netherlands.

Method:

Data were extracted retrospectively from the medical notes of patients consecutively treated for femoral endarterectomy between January 2013 and December 2019 in a single centre in the Netherlands. Since August 2016, patients were treated with the sNPWT device and their data were compared with that of patients treated before the introduction of the device. Data were extracted on SSCs and associated healthcare resource use, with comparisons made between the two patient groups.

Results:

The study included a cohort of 108 patients. Data of patients treated by standard care (n=64) showed 32 (50%) patients developed complications. This reduced significantly in patients treated with the sNPWT device (n=44) of whom eight (18.2%) developed a postoperative complication (p=0.0011). Average postoperative costs per patient were €3119 for those in the standard care group and €2630 where the sNPWT device was used.

Conclusion:

sNPWT provided clinical and economic benefits over standard care in the treatment of femoral endarterectomy patients, significantly reducing rate of complication and their associated costs.

Postoperative wound complications such as surgical site infections (SSIs) and surgical wound dehiscence are a key concern for clinicians and healthcare administrators due to their impact on the patient and the healthcare provider. Such complications are associated with excess morbidity and mortality for the patient and increased treatment costs arising from excess hospital stays.1

SSIs in vascular surgery are relatively more common than average SSI rates across all surgical specialties; (7% vascular versus 5% all surgical).1 Data from the UK estimate that the median excess hospital stay attributable to SSIs in vascular surgery is 9.72 days, with a median incremental cost of £3776 per episode.2

Similarly, wound dehiscence has been shown to be more common within vascular surgeries (5.7% vascular versus 3.0% all surgical).1 In many cases, these wounds will require readmission and further surgical procedures to facilitate wound closure. Where such wounds are not promptly resolved, they can become chronic and complex, requiring ongoing care following discharge, often for many months. Data from the US in 2015, based on a study of over 25,000 wounds, estimated the mean cost of dehiscence at $40,323, with 9.4 days additional hospitalisation for each patient.3

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