Abstract | BACKGROUND: METHODS: A total of 162 diabetic patients with post- amputation wounds (up to the trans-metatarsal level) entered a 16-week, randomized clinical trial. Patients randomized to V.A.C. (n = 77) received therapy with dressing changes every 48 hours. Control patients (n = 85) received standard MWT. Resource utilization, procedures, and direct costs were calculated and analyzed in this post hoc retrospective study. RESULTS: There was no difference between groups for in-patient hospital stay (number of admissions or length of stay). More surgical procedures (including debridement) were required in the MWT group (120 vs 43 NPWT, P <.001). The average number of dressing changes performed per patient was 118.0 (range 12-226) for MWT versus 41 (6-140) for NPWT (P = .0001). The MWT group had 11 (range 0-106) outpatient treatment visits during the study versus 4 (range 0-47) in the NPWT group (P <.05). The average direct cost per patient treated for 8 weeks or longer (independent of clinical outcome) was $27,270 and $36,096 in the NPWT and MWT groups, respectively. The average total cost to achieve healing was $25,954 for patients treated with NPWT (n = 43) compared with $38,806 for the MWT group (n = 33). CONCLUSION: Treatment of diabetic patients with post amputation wounds using NPWT resulted in lower resource utilization and a greater proportion of patients obtaining wound healing at a lower overall cost of care when compared to MWT.
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Authors | Jan Apelqvist, David G Armstrong, Lawrence A Lavery, Andrew J M Boulton |
Journal | American journal of surgery
(Am J Surg)
Vol. 195
Issue 6
Pg. 782-8
(Jun 2008)
ISSN: 1879-1883 [Electronic] United States |
PMID | 18355797
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Amputation, Surgical
(economics)
- Anti-Bacterial Agents
(economics, therapeutic use)
- Bandages
(economics)
- Diabetic Foot
(economics, surgery)
- Female
- Foot
(surgery)
- Health Care Costs
- Health Resources
(statistics & numerical data)
- Humans
- Length of Stay
(economics)
- Male
- Middle Aged
- Negative-Pressure Wound Therapy
(economics)
- Wound Healing
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