Taking the negatives out of negative pressure wound therapy dressings: A cost analysis regarding total joint surgeries

Title : Taking the negatives out of negative pressure wound therapy dressings: A cost analysis regarding total joint surgeries

Abstract:

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.

Biography:

Dylan Salrin is a highly accomplished perioperative nurse educator, leader, and speaker dedicated to advancing nursing practice and education. With a Master’s degree in Nursing Leadership and Administration, Dylan brings extensive experience to his current role at Children’s Hospital Colorado, where he mentors perioperative teams in delivering safe, high-quality care to pediatric patients. As a Board-Certified Orthopaedic Nurse (ONC-A), Dylan specializes in orthopedics and has a talent for breaking down complex clinical concepts into actionable, evidence-based practices. Before his current role, Dylan honed his expertise at UCHealth (University of Colorado Health), where he worked in various nursing capacities, contributing to the growth of his teams and the improvement of patient care outcomes through total joint replacement-focused research. An engaging speaker, Dylan has presented at domestic and international conferences, sharing his insights on topics such as perioperative clinical practice, shortfalls in the representation of the pediatric population in healthcare, and navigating the transition from bedside nurse to leadership roles. His talks are known for their practicality, humor, and ability to inspire both new and experienced nurses. Dylan is also an author, having written Wells in the Wild: Colorado's Trails and Tall Peaks, a children’s book that is distributed through hospitals as well as online libraries. He is currently writing a book for nurses transitioning into leadership roles, addressing challenges such as imposter syndrome and the importance of fostering a supportive and inspired clinical practice. Beyond his professional endeavors, Dylan is deeply involved in community initiatives, including his work with the Rocky Mountain Warm Hands Initiative, which converts wildfire mitigation waste into sustainable green energy in the form of firewood to vulnerable households in need during Colorado’s cold mountain winters. Known for his leadership, mentorship, and commitment to excellence, Dylan continues to leave a lasting impact on the nursing profession and the communities he serves.