Zempsky William T, Zehrer Cindy L, Lyle Christopher T, Hedbloom Edwin C
Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, 282 Washington Street, Hartford, CT 06106, USA.
Int Wound J. 2005 Sep;2(3):272-81. doi: 10.1111/j.1742-4801.2005.00130.x.
Our objective was to review and assess the treatment of low-tension wounds and evaluate the cost-effectiveness of wound closure methods. We used a health economic model to estimate cost/closure of adhesive wound closure strips, tissue adhesives and sutures. The model incorporated cost-driving variables: application time, costs and the likelihood and costs of dehiscence and infection. The model was populated with variable estimates derived from the literature. Cost estimates and cosmetic results were compared. Parameter values were estimated using national healthcare and labour statistics. Sensitivity analyses were used to verify the results. Our analysis suggests that adhesive wound closure strips had the lowest average cost per laceration ($7.54), the lowest cost per infected laceration ($53.40) and the lowest cost per laceration with dehiscence ($25.40). The costs for sutures were $24.11, $69.91 and $41.91, respectively; the costs for tissue adhesives were $28.77, $74.68 and $46.68, respectively. The cosmetic outcome for all three treatments was equivalent. We conclude adhesive wound closure strips were both a cost-saving and a cost-effective alternative to sutures and tissue adhesives in the closure of low-tension lacerations.
我们的目标是回顾和评估低张力伤口的治疗方法，并评估伤口闭合方法的成本效益。我们使用健康经济模型来估计粘性伤口闭合条、组织粘合剂和缝线的每次闭合成本。该模型纳入了成本驱动变量：应用时间、成本以及裂开和感染的可能性及成本。模型中的变量估计值来自文献。比较了成本估计和美容效果。使用国家医疗保健和劳动力统计数据估计参数值。采用敏感性分析来验证结果。我们的分析表明，粘性伤口闭合条的每条撕裂伤平均成本最低（7.54美元），每例感染撕裂伤的成本最低（53.40美元），每例裂开撕裂伤的成本最低（25.40美元）。缝线的成本分别为24.11美元、69.91美元和41.91美元；组织粘合剂的成本分别为28.77美元、74.68美元和46.68美元。三种治疗方法的美容效果相当。我们得出结论，在闭合低张力撕裂伤方面，粘性伤口闭合条相对于缝线和组织粘合剂而言，既是一种节省成本的方法，也是一种具有成本效益的选择。
