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. 2023 Aug 11;110(9):1104-1107.
doi: 10.1093/bjs/znad086.

Cost-effectiveness of replacing versus discarding the nail in children with nail bed injury

Helen A Dakin  1 , Thi Thu An Nguyen  2 , Melina Dritsaki  3   4 , Aina V H Greig  5 , Jamie R Stokes  3 , Jonathan A Cook  3 , David J Beard  3 , Loretta Davies  3 , Matthew D Gardiner  3   6 , Abhilash Jain  3   7 ; NINJA Collaborative
Collaborators, Affiliations

Cost-effectiveness of replacing versus discarding the nail in children with nail bed injury

Helen A Dakin et al. Br J Surg. .
No abstract available

Plain language summary

Every year in the UK, around 10 000 children need to have operations to mend injuries to the bed of their fingernails. Currently, most children have their fingernail placed back on the injured nail bed after the operation. The NINJA trial found that children were slightly less likely to have an infection if the nail was thrown away rather than being put back, but the difference between groups was small and could have be due to chance. This study looked at whether replacing the nail is cost-effective compared with throwing it away. Using data from the NINJA trial, we compared costs, healthcare use, and quality of life and assessed the cost-effectiveness of replacing the nail. It was found that throwing the nail away after surgery would save the National Health Service (NHS) £75 (€85) per operation compared with placing the nail back on the nail bed. Changing clinical practice could save the NHS in England £720 000 (€819 000) per year.

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Figures

Fig. 1
Fig. 1
Cost-effectiveness acceptability curves for base-case and sensitivity analyses This shows the probability that replacing the nail is good value for money at different estimates of the amount that the National Health Service (NHS) might be willing to pay to avoid one nail bed infection. It quantifies the uncertainty there is around the conclusions, given the trial results and the lack of evidence about how much it is worth paying to avoid one infection. To highlight differences between analyses, the y-axis shows only the 0–12% range. Cost-effectiveness analysis 1 (CEA1) comprised a complete-case analysis (excluding any patients with missing data on 7-day infections or resources at 7–10 days), took a 7–10-day time horizon, and excluded the cost of all drugs (including antibiotics).
See this image and copyright information in PMC

References

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