Use of a home vacuum-assisted closure device in the burn population is both cost-effective and efficacious

Mushin, Oren P.; Bogue, Jarrod T; Esquenazi, Mica D.; Toscano, Nicole; Bell, Derek

doi:10.1016/j.burns.2016.08.038

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Its mechanism of action has yet to be characterised definitively, but it is likely multifactorial, with research indicating potential activity in reducing oedema formation and burn wound conversion, modulating inflammation and extracellular matrix degradation, and stimulating neovascularisation and cellular proliferation 16 , 17 , 34 , 35 . However, the therapy’s effects on overall healthcare costs in acute burn management have thus far remained largely unexplored 18 , 19 , notwithstanding some limited investigations into its cost-effectiveness as a bolster for skin grafts 36 , 37 . None of the previously-published randomised controlled trials focusing on spontaneous healing with NPWT reported the collection of any cost data 20 – 22 .…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of adjunctive negative pressure wound therapy in paediatric burn care: evidence from the SONATA in C randomised controlled trial

Frear

Griffin

Cuttle

et al. 2021

Sci Rep

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Negative pressure wound therapy (NPWT) has been shown to improve clinical outcomes for children with burns by accelerating wound re-epithelialisation. Its effects on healthcare costs, however, remain poorly understood. The aim of this study was to evaluate the cost-effectiveness of NPWT from a healthcare provider perspective using evidence from the SONATA in C randomised controlled trial, in which 101 children with small-area burns were allocated to either standard care (silver-impregnated dressings) or standard care in combination with adjunctive NPWT. The primary outcome, time to re-epithelialisation, was assessed through a blinded photographic review. Resource usage and costs were prospectively recorded for each participant for up to 6 months. Incremental cost-effectiveness ratios and dominance probabilities were estimated and uncertainty quantified using bootstrap resampling. Mean costs per participant—including dressings, labour, medication, scar management, and theatre operations—were lower in the NPWT group (AUD $903.69) relative to the control group (AUD $1669.01). There was an 89% probability that NPWT was dominant, yielding both faster re-epithelialisation and lower overall costs. Findings remained robust to sensitivity analyses employing alternative theatre costs and time-to-re-epithelialisation estimates for grafted patients. In conclusion, adjunctive NPWT is likely to be a cost-effective and dominant treatment for small-area paediatric burns (ANZCTR.org.au:ACTRN12618000256279).

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of adjunctive negative pressure wound therapy in paediatric burn care: evidence from the SONATA in C randomised controlled trial

Frear

Griffin

Cuttle

et al. 2021

Sci Rep

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“…In recent years, some simplified NPWT devices have been developed, with proven efficacy. Previous studies 13-15 mainly compared the cost and length of hospital stay between traditional and simplified NPWT. These studies demonstrated that simplified NPWT is an effective alternative treatment due to its low cost and reduced hospital stay duration.…”

Section: Discussionmentioning

confidence: 99%

An Application of a Negative-Pressure Wound Dressing for Partial- or Full-Thickness Burn Wounds

Cheng

Zhou

et al. 2020

The International Journal of Lower Extremity Wounds

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Negative-pressure wound therapy is widely used in burn populations. Traditionally, negative-pressure devices use persistent vacuum suction, requiring a longer hospital stay. In this study, we applied a novel negative-pressure wound dressing for burn wounds, which eliminates the hospital stay. The medical records of 39 patients with partial-/full-thickness burns treated by negative-pressure wound dressing were retrospectively analyzed. The average burn area, burn degree, healing duration, cost, and incidents during treatment were determined and compared with previous data for conventional therapies. In conclusion, for patients diagnosed with partial-thickness or full-thickness burns and a burn area <34.6 ± 2.21 cm2, the negative-pressure wound dressing is a reliable option, especially for burnt children. Moreover, the negative-pressure wound dressing treatment was not only much cheaper than conventional therapies, but also eliminated hospital stay in patients with small-area deep burn wounds.

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“…137 Some centers are demonstrating the safety and cost-effectiveness of outpatient burn surgery, 138 and incorporating home negative-pressure wound therapy devices to facilitate this shift. 139 Once autografts have taken, a comprehensive program of burn scar management should begin, including but not limited to physical and occupational therapy, massage, hydration, splinting, and compression garments.…”

Section: Postoperative Carementioning

confidence: 99%

Acute Burn Care

Davis,

Xu,

Gottlieb

et al. 2024

Plastic &Amp; Reconstructive Surgery

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Learning Objectives: After studying this article and viewing the videos, the participant should be able to: 1. Describe the current epidemiology of burn injuries. 2. Understand burn pathophysiology and perform a wound assessment. 3. Summarize the initial emergency management of a burn patient. 4. Calculate the anticipated fluid resuscitation requirements for a burn injury, and diagnose the complications of overresuscitation. 5. Describe the diagnosis and management of inhalation injury. 6. List the goals of wound care for superficial and deep burns, and describe the closed dressing technique. 7. Perform excision of a burn wound. 8. Compare various wound closure techniques using autografts and skin substitutes. Summary: Plastic surgeons are essential members of the multidisciplinary burn team. Burn injuries remain common, and plastic surgeons have an opportunity to develop and innovate the field of acute burn care in light of workforce shortages. Burn pathophysiology is complex and dynamic, which informs the challenges encountered during the perioperative phase. Accurate burn wound assessment remains difficult, with implications for diagnosis and management. A systematic approach is required when stabilizing a major burn and/or inhalation injury with newly updated fluid resuscitation and triage guidelines. Wound care continues to evolve, with an emphasis on a closed dressing technique. For deeper burns, new surgical techniques are emerging for surgical débridement, along with improvements to traditional methods of tangential excision. Following excision, a number of established and novel techniques are available to close the wound with either autografts or skin substitutes.

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Use of a home vacuum-assisted closure device in the burn population is both cost-effective and efficacious

Cited by 6 publications

References 15 publications

Cost-effectiveness of adjunctive negative pressure wound therapy in paediatric burn care: evidence from the SONATA in C randomised controlled trial

Cost-effectiveness of adjunctive negative pressure wound therapy in paediatric burn care: evidence from the SONATA in C randomised controlled trial

An Application of a Negative-Pressure Wound Dressing for Partial- or Full-Thickness Burn Wounds

Acute Burn Care

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