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document
Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds . BACKGROUND To evaluate resource utilization and direct economic costs of care for patients treated with negative-pressure wound therapy ( NPWT ) , using the Vacuum-Assisted Closure ( V.A.C . ) system , compared to standard moist wound therapy ( MWT ) . METHODS A total of 162 diabetic patients with post-amputation wounds ( up to the trans-metatarsal level ) entered a 16-week , randomized clinical trial . Patients randomized to V.A.C . ( n = 77 ) received therapy with dressing changes every 48 hours . Control patients ( n = 85 ) received standard MWT . Resource utilization , procedures , and direct costs were calculated and analyzed in this post hoc retrospective study . RESULTS There was no difference between groups for in-patient hospital stay ( number of admissions or length of stay ) . More surgical procedures ( including debridement ) were required in the MWT group ( 120 vs 43 NPWT , P < .001 ) . The average number of dressing changes performed per patient was 118.0 ( range 12-226 ) for MWT versus 41 ( 6-140 ) for NPWT ( P = .0001 ) . The MWT group had 11 ( range 0-106 ) outpatient treatment visits during the study versus 4 ( range 0-47 ) in the NPWT group ( P < .05 ) . The average direct cost per patient treated for 8 weeks or longer ( independent of clinical outcome ) was $ 27,270 and $ 36,096 in the NPWT and MWT groups , respectively . The average total cost to achieve healing was $ 25,954 for patients treated with NPWT ( n = 43 ) compared with $ 38,806 for the MWT group ( n = 33 ) . CONCLUSION Treatment of diabetic patients with post amputation wounds using NPWT resulted in lower resource utilization and a greater proportion of patients obtaining wound healing at a lower overall cost of care when compared to MWT .
35141
Intervention_Physical
vacuum-assisted closure therapy
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Intervention_Physical
negative-pressure wound therapy ( NPWT )
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Intervention_Physical
the Vacuum-Assisted Closure ( V.A.C . ) system
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Intervention_Physical
standard moist wound therapy ( MWT )
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Intervention_Physical
V.A.C .
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Intervention_Physical
therapy with dressing changes
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Intervention_Physical
MWT
35148
Intervention_Physical
MWT
35149
Intervention_Physical
NPWT
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Intervention_Physical
MWT
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Intervention_Physical
NPWT
35152
Intervention_Physical
MWT
35153
Intervention_Physical
NPWT
35154
Intervention_Physical
NPWT
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Intervention_Physical
MWT
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Intervention_Physical
NPWT
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Intervention_Physical
MWT
35158
Outcome_Other
resource utilization
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Outcome_Other
direct economic costs
35160
Outcome_Other
Resource utilization
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Outcome_Other
procedures
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Outcome_Other
direct costs
35163
Outcome_Other
in-patient hospital stay ( number of admissions or length of stay )
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Outcome_Other
average number of dressing changes performed per patient
35165
Outcome_Other
outpatient treatment visits
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Outcome_Other
average direct cost per patient
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Outcome_Other
average total cost to achieve healing
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Outcome_Other
resource utilization
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Outcome_Other
lower overall cost of care
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Participant_Condition
diabetic foot wounds
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Participant_Sample-size
162
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Participant_Condition
diabetic
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Participant_Condition
post-amputation
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Participant_Sample-size
77
35175
Participant_Sample-size
85
35176
Participant_Condition
diabetic
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Participant_Condition
post amputation wounds