Title : Taking the negatives out of negative pressure wound therapy dressings: A cost analysis regarding total joint surgeries
Background: It is common for facilities to use standard compressive dressings (Aquacel) for complex total joint replacements, revisions, and irrigation and debridements. ?Significant variation and unpredictability existed in outcomes. Existing literature suggests that NPWT ?dressings (PICO) can improve outcomes and ?minimize admit times. Hesitancy to implement PICO dressing exists due to initial cost. Current contracted prices of PICO dressings are $250 per unit with Aquacel pricing at $37. Average cost of a medical/surgical floor admission is estimated at $3,000/day.?
Purpose: Analyze overall cost savings on admission times due to improved outcomes regarding total joint arthroplasty surgeries.
Methods: Total of 48 participants: 24 in each (study vs. control) group. Age, BMI, ASA score, diabetic status, and revision vs. primary surgery recorded for each patient. Post-surgical complications were recorded at two-week visits. Parametric analysis was utilized to identify correlation and/or a causal relationship between the above parameters and hospitalization time.
Results/Outcomes: Statistical analysis showed no correlation between other parameters (e.g., age, BMI, ASA score) and hospitalization time. The findings show that patients who are equipped with the PICO dressing are consistently discharged faster than Aquacel patients. Utilization of the PICO dressing results in a $1,482.46 cost savings on average inpatient stay. Post-surgical complications were twice as great for Aquacel patients as compared to PICO patients.
Discussion/Implications: The only observable parameter consistently influencing improved discharge time is the type of dressing, strongly suggesting a causal relationship between type of dressing and admit time. Multiple participants in the study group had previous experience with Aquacel and were able to make direct (subjective) comparisons in regards to comfort and experience. A bilateral knee replacement surgery was conducted with both dressings applied. Edema was noted on Aquacel-applied knee, one-day post-op. Patient noted increased perfusion and less swelling on PICO-applied knee. The initial increased cost of NPWT (PICO) dressings are offset by the significant savings. Improved outcomes, reduced complications, and increased satisfaction are also significant findings of advantages of the PICO dressing. The cost-benefits are apparent when applying PICO dressings on high-risk patients. The suggested implication for practice is to utilize on revision surgeries.