Negative Pressure Wound Therapy Literature Review of Efficacy, Cost Effectiveness, and Impact on Patients' Quality of Life in Chronic Wound Management and Its Implementation in the United Kingdom

Abstract

This is a paper reviewing the National Health Service (NHS) agenda in relation to the use of Negative Pressure Wound Therapy (NPWT) in chronic wound management and assesses the evidence behind it, its cost effectiveness and the outcome it has on patients' satisfaction and life style. Multiple studies over the last 10 years looking at clinical efficacy of NPWT with its cost effectiveness and the implementation of this service in the UK were reviewed. NPWT has showed a reasonable body of evidence to support its usage in chronic wounds with potential positive outcomes on finance and patients' satisfaction. However, the NHS system shows significant variations in the availability and implementation of this useful tool, depending on care providers and resources availabilities. The paper concluded that the NPWT can be a useful source of cutting down costs of chronic wound managements and saving money by its effect on expediting wound healing, which can address a part of the financial crises facing the NHS, however, has to be considered according to specific case needs. There should also be a national standard for the availability and indication of this tool to assure equal opportunities for different patients in different areas in the country.

Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy

“…There have been a number of reviews of NPWT [4][5][6][7][8] , with some favouring NPWT over standard dressings [5,6] and others failing to find convincing evidence of benefit [4,7,8].…”

“…The majority of these focus either primarily or entirely on studies of NPWT in the treatment setting [5][6][7][8], although a Cochrane review of NPWT for prophylactic postoperative use concluded that the evidence for effectiveness was unclear [4].…”

“…Other researchers have concluded that NPWT is cost-effective compared to standard treatment in retrospective chart reviews [11] and comparative case-studies [12]. The results of these studies are highly uncertain and generalisability is limited by the heterogeneity of patients receiving NPWT [6]. Additionally, most cost-effectiveness studies have focused on the treatment of chronic, difficult-to-heal wounds [6,10,11].…”

“…The results of these studies are highly uncertain and generalisability is limited by the heterogeneity of patients receiving NPWT [6]. Additionally, most cost-effectiveness studies have focused on the treatment of chronic, difficult-to-heal wounds [6,10,11]. NPWT is increasingly used prophylactically following surgery for high-risk clean wounds [13], particularly in obese patients at greater risk of developing SSIs [14].…”

Negative pressure wound therapy versus healing by secondary intention in pressure ulcers

“…Similarly, in various acute or chronic wounds, others reported better QoL. 30,39 In fact, a true cost analysis was not performed. Wanner, 28 wrote only that NPWT was "cheaper than the traditional dressings".…”