The first topic concerns the cost-effectiveness of NPWT. In the United States, an estimated $1.7 billion is spent annually on wound management for patients with acute and chronic wounds. (Suissa, Danino and Nikolis 2011). Expenses are expected to increase as the elderly population grows. NPWT is commonly used in various clinical settings in the management of different types of wounds, which will be simple or complicated. Nather et al. (2010) noted that to minimize the cost of VAC therapy, adequate tissue granulation in a wound was required prior to the application of NPWT, which will ensure convenience in the use of VAC therapy. As suggested by Nain et al. (2011) that NPWT is cost-effective in the treatment of diabetic foot ulcers because it improves wound closure in a short period. However, this amount does not include hospitalization costs, which can significantly impact the total cost of the patient being treated. In Singapore, VAC therapy costs $100 per day for an inpatient receiving treatment (Nather et al. 2010, p. 358). However, according to Ashby et al. (2012, p. 14), “NPWT may cost less and be more effective than other treatments, the decision to use NPWT remains highly uncertain; thus this treatment may, in fact, not be cost-effective.” Meanwhile, cost was not included in Yao et al.'s (2012) studies in consideration of the effectiveness of NPWT. However, it is important to include cost when studying the reliability of NPWT costs in using NPWT The second theme concerns the methods of application, the application of NPWT varies according to the thickness of the wound and the type... at the center of the paper... the level of comfort for a patient after the application of an NPWT is considerably important. Two out of three articles used a standard negative pressure applied to the wound or as recommended by the manufacturer's guidelines, i.e. -125 mmHg (Nather et al. 2010 and Suissa, Danino and Nikolis 2011). While Nain et al. (2011, p. 3) suggested that “subatmospheric (negative) pressure was applied in a range of −50 mmHg to −125 mmHg intermittently three times per day.” The use of customizable continuous or intermittent pressure therapy will provide comfort to the patient. In the study by Nather et al. (2010), to address concerns such as when the patient began to experience pain or excessive bleeding occurred in the wound, a lower pressure of -75 to -100 mmHg was set. Therefore, it is imperative that the patient takes appropriate action in treating his wound.
tags