Systematic Review of Dressing Usage and Cost Analysis for Two Closed Incision Negative Pressure Therapy Systems

Currently, there are two main commercially available closed incision negative pressure therapy (ciNPT) systems: one using a foam dressing (FOAM*) and another with a multilayer absorbent (MLA†) dressing. Meta-analyses have shown that patients treated postoperatively with the FOAM system have significantly lower rates of surgical site infections (SSIs) when compared to conventional dressings, whereas patients treated postoperatively with the MLA system did not.

In this study, we compared dressing usage and costs associated with SSIs in four different surgery types; eight randomized controlled trials (RCTs) with 532 MLA-treated patients and nine RCTs with 489 FOAM-treated patients were analyzed. The cost per SSI for each surgery type was based on a fixed amount reported in previously published studies2-4 and was equal for both ciNPT systems.

The total cost per patient was calculated as the cost of SSI per patient plus the price of therapy per patient, which was dependent on the number of ciNPT kits used. Overall, an average of 1.5 MLA kits per patient was used, whereas one FOAM kit per patient was used. An overall savings of $2,702 per patient was determined when comparing the FOAM system to conventional dressings and factoring in the cost of SSIs, with colorectal surgeries having the highest degree of savings due primarily to the high cost of SSI in this surgery type.

An overall savings of $499 per patient was determined when comparing the MLA system to conventional dressings and factoring in the cost of SSIs; however, these savings were reduced to $267-$409 per patient when factoring in the number of MLA kits needed for treatment and the different types of MLA products. These data suggest that ciNPT systems using foam dressings can provide significant savings, especially as the cost of treating an SSI increases.