The 10x Cost: When Does an Expensive Surgical Dressing Actually Make Sense?

A matched cohort study reveals why closed incision negative pressure wound therapy (ciNPWT) is a game changer for high-risk patients.

Despite the clinical success of primary total knee arthroplasty (TKA), surgical site complications (SSCs) including surgical site infections (SSIs) and wound healing complications are a leading cause of morbidity, unplanned early readmission, delayed return to work, and economic burden. Patients with superficial SSIs are also more likely to develop deep periprosthetic joint infection (PJI), a devastating complication.

Concurrent with the increasing number of surgeries performed in the last two decades, the overall medical comorbidity burden of patients undergoing primary TKA has risen dramatically. Closed incision negative pressure wound therapy (ciNPWT) is one method for reducing SSCs. First introduced in 1997, in the form of vacuum-assisted closure, negative pressure therapy has long been considered the gold standard for treatment of acute and chronic open wounds. This technology has since been expanded to at-risk incisions in the form of ciNPWT.

However, a similarly sized ciNPWT dressing costs a hospital nearly 10 times as much as a standard occlusive silver impregnated dressing ($389.99 vs. $35.22). We wanted to know if this massive cost difference was truly justified for high-risk patients.