Saramago Pedro, Gkekas Athanasios, Arundel Catherine E, Chetter Ian C
Centre for Health Economics, University of York, York, UK.
York Trials Unit, University of York, York, UK.
Br J Surg. 2025 Apr 30;112(5). doi: 10.1093/bjs/znaf077.
Negative pressure wound therapy (NPWT) has been used in clinical practice for surgical wounds healing by secondary intention (SWHSI), despite limited evidence regarding its clinical effectiveness and cost-effectiveness. The aim of this study was to evaluate the cost-effectiveness of NPWT for SWHSI, compared with standard dressings, from the perspective of the UK healthcare system.
An economic model was used to extrapolate the effectiveness results of a meta-analysis over a patient's lifetime and estimate the costs and outcomes (quality-adjusted life-years (QALYs)) of NPWT and standard dressings. The probability of NPWT being cost-effective was estimated, with extensive scenario analyses conducted to evaluate the robustness of results and the degree of uncertainty.
On average, NPWT was associated with higher costs and marginally higher QALYs than standard dressings. The cost difference was mainly driven by the additional intervention costs associated with NPWT. The estimated probability of NPWT being cost-effective was <30%. There was considerable uncertainty in the findings, driven largely by uncertainty in the estimated pooled relative effect from the meta-analysis. Results were robust to different scenario analyses.
No evidence was found demonstrating that NPWT was a cost-effective alternative to standard dressings for SWHSI.
负压伤口治疗（NPWT）已用于临床实践中二期愈合的手术伤口（SWHSI），尽管关于其临床有效性和成本效益的证据有限。本研究的目的是从英国医疗保健系统的角度评估NPWT治疗SWHSI相对于标准敷料的成本效益。
采用经济模型推断患者一生中荟萃分析的有效性结果，并估计NPWT和标准敷料的成本及结果（质量调整生命年（QALY））。估计NPWT具有成本效益的概率，并进行广泛的情景分析以评估结果的稳健性和不确定性程度。
平均而言，与标准敷料相比，NPWT的成本更高，QALY略高。成本差异主要由与NPWT相关的额外干预成本驱动。NPWT具有成本效益的估计概率<30%。研究结果存在相当大的不确定性，主要是由荟萃分析估计的合并相对效应的不确定性驱动的。结果对不同的情景分析具有稳健性。
未发现证据表明NPWT是SWHSI标准敷料的成本效益替代方案。
