The $390 Dressing: Is ciNPWT Worth the Cost for Knee Replacements?

A matched cohort study reveals how closed incision negative pressure wound therapy cuts complications by more than half.

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. This is incredibly serious, as 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 2 decades, the overall medical comorbidity burden of patients undergoing primary TKA has risen dramatically , resulting in a larger total “at-risk” population. Closed incision negative pressure wound therapy (ciNPWT) is one method for reducing SSCs. However, for uncomplicated cases, surgeons should recognize the significant up-front cost difference between the 2 dressings. At our institution, the silver impregnated dressing costs $35.22, whereas a similarly sized ciNPWT dressing costs $389.99, representing a nearly 10-fold greater up-front cost per surgery.