Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden.
Department of Global Public Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
World J Emerg Surg. 2022 Feb 10;17(1):9. doi: 10.1186/s13017-022-00415-1.
Clinical outcomes after negative-pressure wound therapy (NPWT) and standard treatment of conflict-related extremity wounds are similar. In resource-limited settings, cost affects the choice of treatment. We aimed to estimate treatment-related costs of NPWT in comparison with standard treatment for conflict-related extremity wounds.
We derived outcome data from a randomized, controlled superiority trial that enrolled adult (≥ 18 years) patients with acute (≤ 72 h) conflict-related extremity wounds at two civilian hospitals in Jordan and Iraq. Primary endpoint was mean treatment-related healthcare costs (adjusted to 2019 US dollars).
Patients were enrolled from June 9, 2015, to October 24, 2018. A total of 165 patients (155 men [93.9%]; 10 women [6.1%]; and median [IQR] age, 28 [21-34] years) were included in the analysis. The cost per patient treated with NPWT was $142 above that of standard treatment. Overall, results were robust in a sensitivity analysis.
With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings. Trial registration NCT02444598.
负压伤口治疗（NPWT）和冲突相关四肢伤口标准治疗后的临床结果相似。在资源有限的环境下，成本会影响治疗选择。我们旨在评估 NPWT 与冲突相关四肢伤口的标准治疗相比的治疗相关成本。
我们从一项在约旦和伊拉克的两家平民医院开展的、随机、对照的优势试验中获得了结局数据，该试验纳入了急性（≤72 小时）冲突相关四肢伤口的成年（≥18 岁）患者。主要终点是治疗相关的医疗保健成本的平均值（调整至 2019 年美元）。
患者于 2015 年 6 月 9 日至 2018 年 10 月 24 日入组。共纳入 165 名患者（155 名男性[93.9%]；10 名女性[6.1%]；中位数[IQR]年龄为 28[21-34]岁）进行分析。与标准治疗相比，接受 NPWT 治疗的每位患者的成本增加了 142 美元。总的来说，敏感性分析的结果是稳健的。
与标准护理相比，NPWT 的临床结果相似，因此我们的结果不支持在资源匮乏环境下的平民医院对冲突相关四肢伤口的常规治疗中使用 NPWT。临床试验注册号：NCT02444598。
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