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Meta-Analysis
. 2025 Apr 30;112(5):znaf077.
doi: 10.1093/bjs/znaf077.

Negative pressure wound therapy for surgical wounds healing by secondary intention is not cost-effective

Pedro Saramago  1 , Athanasios Gkekas  2 , Catherine E Arundel  2 , Ian C Chetter  3   4   5 ; SWHSI-2 Trial Investigators
Collaborators, Affiliations
Meta-Analysis

Negative pressure wound therapy for surgical wounds healing by secondary intention is not cost-effective

Pedro Saramago et al. Br J Surg. .

Abstract

Background: Negative pressure wound therapy (NPWT) has been used in clinical practice for surgical wounds healing by secondary intention (SWHSI), despite limited evidence regarding its clinical effectiveness and cost-effectiveness. The aim of this study was to evaluate the cost-effectiveness of NPWT for SWHSI, compared with standard dressings, from the perspective of the UK healthcare system.

Methods: An economic model was used to extrapolate the effectiveness results of a meta-analysis over a patient's lifetime and estimate the costs and outcomes (quality-adjusted life-years (QALYs)) of NPWT and standard dressings. The probability of NPWT being cost-effective was estimated, with extensive scenario analyses conducted to evaluate the robustness of results and the degree of uncertainty.

Results: On average, NPWT was associated with higher costs and marginally higher QALYs than standard dressings. The cost difference was mainly driven by the additional intervention costs associated with NPWT. The estimated probability of NPWT being cost-effective was <30%. There was considerable uncertainty in the findings, driven largely by uncertainty in the estimated pooled relative effect from the meta-analysis. Results were robust to different scenario analyses.

Conclusion: No evidence was found demonstrating that NPWT was a cost-effective alternative to standard dressings for SWHSI.

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Figures

Fig. 1
Fig. 1
Economic model structure for SWHSI SWHSI, surgical wounds healing by secondary intention; ONS, Office for National Statistics; HRQoL, health-related quality of life; QALYs, quality-adjusted life-years; NPWT, negative pressure wound therapy; GP, general practitioner; inc., including; A&E, accident and emergency.
Fig. 2
Fig. 2
Movement through the economic model health states for the initial 5 years for both the NPWT group and the standard dressings group SWHSI, surgical wounds healing by secondary intention; NPWT, negative pressure wound therapy.
Fig. 3
Fig. 3
Incremental NMB for a range of cost-effectiveness thresholds NMB, net monetary benefit; QALY, quality-adjusted life-year.
See this image and copyright information in PMC

References

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