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Randomized Controlled Trial
. 2022 Feb 10;17(1):9.
doi: 10.1186/s13017-022-00415-1.

Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial

Andreas Älgå  1   2 , Jenny Löfgren  3 , Rawand Haweizy  4 , Khaldoon Bashaireh  5   6 , Sidney Wong  7 , Birger C Forsberg  8 , Johan von Schreeb  8 , Jonas Malmstedt  9
Affiliations
Randomized Controlled Trial

Cost analysis of negative-pressure wound therapy versus standard treatment of acute conflict-related extremity wounds within a randomized controlled trial

Andreas Älgå et al. World J Emerg Surg. .

Abstract

Background: Clinical outcomes after negative-pressure wound therapy (NPWT) and standard treatment of conflict-related extremity wounds are similar. In resource-limited settings, cost affects the choice of treatment. We aimed to estimate treatment-related costs of NPWT in comparison with standard treatment for conflict-related extremity wounds.

Methods: We derived outcome data from a randomized, controlled superiority trial that enrolled adult (≥ 18 years) patients with acute (≤ 72 h) conflict-related extremity wounds at two civilian hospitals in Jordan and Iraq. Primary endpoint was mean treatment-related healthcare costs (adjusted to 2019 US dollars).

Results: Patients were enrolled from June 9, 2015, to October 24, 2018. A total of 165 patients (155 men [93.9%]; 10 women [6.1%]; and median [IQR] age, 28 [21-34] years) were included in the analysis. The cost per patient treated with NPWT was $142 above that of standard treatment. Overall, results were robust in a sensitivity analysis.

Conclusions: With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings. Trial registration NCT02444598.

Keywords: Armed conflict; Cost analysis; Trauma; Wounds.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trial profile. NPWT, negative-pressure wound therapy; LAMA, left against medical advice
Fig. 2
Fig. 2
Mean costs per treated patient. Currency data are in 2019 US dollars. NPWT, negative-pressure wound therapy
See this image and copyright information in PMC

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