The clinical and cost effectiveness of externally applied negative pressure wound therapy in the treatment of wounds in home healthcare Medicare patients

Abstract

Pressure ulcers, a devastating and costly healthcare problem, often occur in home healthcare settings. We sought to determine if these and other chronic wounds treated at home with negative pressure wound therapy close faster and reduce treatment costs compared to conventional therapies. Records for 1,032 Medicare home healthcare patients with 1,170 wounds that failed to respond to previous interventions--and were subsequently treated with negative pressure wound therapy--were reviewed. Reductions in wound area and volume were compared to rates reported by Ferrell in 1993, and costs were analyzed. Ferrell reported trochanteric and trunk pressure ulcers averaging 4.3 cm2, treated with a low-air-loss surface and saline-soaked gauze closed at an average of 0.090 cm2 per day. For comparison to Ferrell's outcomes, we analyzed our Stage III and IV trochanteric and trunk wounds treated with low-air-loss and negative pressure wound therapy. Ours averaged 22.2 cm2 in area and closed at an average of 0.23 cm2 per day. The average 22.2 cm2 wound in our study, treated as described by Ferrell, would take 247 days to heal and cost $23,465. Using negative pressure wound therapy, the wound would heal in 97 days and cost $14,546. The study concluded that negative pressure wound therapy is an efficacious and economical treatment modality for a variety of chronic wounds.