Kim Jeff J, Franczyk Mieczyslawa, Gottlieb Lawrence J, Song David H
Section of Plastic and Reconstructive Surgery, Department of Surgery, University of Chicago Medicine and Biological Sciences, Chicago, Ill.; and Department of Therapy Services, University of Chicago Medical Center, Chicago, Ill.
Plast Reconstr Surg Glob Open. 2017 Feb 6;5(2):e1211. doi: 10.1097/GOX.0000000000001211. eCollection 2017 Feb.
Current predominantly used equipments for negative-pressure wound therapy (NPWT) are expensive. In current healthcare climate continually emphasizing cost containment, importance in developing more cost-effective alternatives cannot be understated. Previously, therapeutically equivalent methods of providing NPWT was demonstrated using just low-cost, universally available supplies, coined Gauze-SUCtion (GSUC). Here, we examine long-term potential financial savings of utilizing GSUC over commercialized products.
A retrospective cost analysis was performed at the University of Chicago Medical Center between 1999 and 2014. All NPWT was provided via either GSUC or commercialized vacuum-assisted closure (VAC, KCI) device. Sum of all material component costs were reviewed to determine theoretical average daily cost. For the VAC group, recorded institutional spend to KCI was also reviewed to determine actual daily cost. In the GSUC group, this figure was extrapolated using similar ratios. Labor costs for each method were determined using analysis from prior study. Patient demographics, etiology, wound location, and treatment length were also reviewed.
Total of 35,871 days of NPWT was provided during the 15-year span. Theoretical average cost of VAC was $94.01/d versus $3.61/d for GSUC, whereas actual average was $111.18/d versus $4.26/d. Average labor cost was $20.11/dressing change versus $12.32. Combined, total cost of VAC therapy was estimated at $119,224 per every 1,000 days of therapy versus $9,188 for the GSUC.
There is clear and significant cost savings from utilization of GSUC method of NPWT. Furthermore, the added advantage of being able to provide NPWT from universally accessible materials cannot be overstated.
目前主要使用的负压伤口治疗（NPWT）设备价格昂贵。在当前持续强调成本控制的医疗环境下，开发更具成本效益的替代方案的重要性再怎么强调也不为过。此前，已证明仅使用低成本、普遍可得的用品就能提供治疗等效的NPWT方法，即纱布抽吸法（GSUC）。在此，我们研究使用GSUC相对于商业化产品的长期潜在财务节省情况。
于1999年至2014年在芝加哥大学医学中心进行回顾性成本分析。所有NPWT均通过GSUC或商业化的真空辅助闭合（VAC，KCI）设备提供。审查所有材料成分成本的总和以确定理论平均每日成本。对于VAC组，还审查了向KCI记录的机构支出以确定实际每日成本。在GSUC组中，该数字使用类似比率进行外推。每种方法的劳动力成本通过先前研究的分析来确定。还审查了患者人口统计学、病因、伤口位置和治疗时长。
在15年期间共提供了35,871天的NPWT。VAC的理论平均成本为94.01美元/天，而GSUC为3.61美元/天，而实际平均成本分别为111.18美元/天和4.26美元/天。平均劳动力成本为每次换药20.11美元，而GSUC为12.32美元。综合来看，VAC治疗的总成本估计为每1000天治疗119,224美元，而GSUC为9,188美元。
使用GSUC方法进行NPWT可明显且显著地节省成本。此外，能够使用普遍可得的材料提供NPWT这一额外优势再怎么强调也不为过。
