Cost study of dermal substitutes and topical negative pressure in the surgical treatment of burns

• Published in: Burns Vol. 40; no. 3; pp. 388 - 396
• Main Authors: Hop, M. Jenda, Bloemen, Monica C.T, van Baar, Margriet E, Nieuwenhuis, Marianne K, van Zuijlen, Paul P.M, Polinder, Suzanne, Middelkoop, Esther
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.05.2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Burns; Burns - economics; Burns - surgery; Costs; Costs and Cost Analysis; Critical Care; Dermal substitutes; Female; Health Care Costs; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy - economics; Skin Transplantation - economics; Skin, Artificial - economics; Topical negative pressure; Young Adult; Costs; Dermal substitutes; Topical negative pressure; Burns
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2013.08.025

Abstract Background A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment. Methods The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity. Results Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP ( p = 0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 ( p < 0.001). However, mean total costs per patient did not differ significantly between groups (range €29 097–€43 774). Discussion Costs of the interventional treatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role.