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Abstract
Negative pressure wound therapy (NPWT) has been shown to improve clinical outcomes for children with burns by accelerating wound re-epithelialisation. Its effects on healthcare costs, however, remain poorly understood. The aim of this study was to evaluate the cost-effectiveness of NPWT from a healthcare provider perspective using evidence from the SONATA in C randomised controlled trial, in which 101 children with small-area burns were allocated to either standard care (silver-impregnated dressings) or standard care in combination with adjunctive NPWT. The primary outcome, time to re-epithelialisation, was assessed through a blinded photographic review. Resource usage and costs were prospectively recorded for each participant for up to 6 months. Incremental cost-effectiveness ratios and dominance probabilities were estimated and uncertainty quantified using bootstrap resampling. Mean costs per participant—including dressings, labour, medication, scar management, and theatre operations—were lower in the NPWT group (AUD $903.69) relative to the control group (AUD $1669.01). There was an 89% probability that NPWT was dominant, yielding both faster re-epithelialisation and lower overall costs. Findings remained robust to sensitivity analyses employing alternative theatre costs and time-to-re-epithelialisation estimates for grafted patients. In conclusion, adjunctive NPWT is likely to be a cost-effective and dominant treatment for small-area paediatric burns (ANZCTR.org.au:ACTRN12618000256279).
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Details
1 The University of Queensland, Centre for Children’s Burns and Trauma Research, Level 7, Child Health Research Centre, South Brisbane, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537); University of Queensland, Faculty of Medicine, Herston, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537)
2 The University of Queensland, Centre for Children’s Burns and Trauma Research, Level 7, Child Health Research Centre, South Brisbane, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537); Griffith University, Menzies Health Institute Queensland, Southport, Australia (GRID:grid.1022.1) (ISNI:0000 0004 0437 5432)
3 The University of Queensland, Centre for Children’s Burns and Trauma Research, Level 7, Child Health Research Centre, South Brisbane, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537); Queensland University of Technology, School of Biomedical Sciences, Faculty of Health, Brisbane, Australia (GRID:grid.1024.7) (ISNI:0000000089150953)
4 The University of Queensland, Centre for Children’s Burns and Trauma Research, Level 7, Child Health Research Centre, South Brisbane, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537); University of Queensland, Faculty of Medicine, Herston, Australia (GRID:grid.1003.2) (ISNI:0000 0000 9320 7537); Queensland Children’s Hospital, South Brisbane, Australia (GRID:grid.240562.7)
5 Queensland University of Technology, Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Brisbane, Australia (GRID:grid.1024.7) (ISNI:0000000089150953); Metro South Health, Clinical Informatics Directorate, Brisbane, Australia (GRID:grid.474142.0)