Document Detail


Economic and clinical contributions of an antimicrobial barrier dressing: a strategy for the reduction of surgical site infections.
MedLine Citation:
PMID:  20653399     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: In patients at risk of surgical site infection (SSI), there is evidence that an antimicrobial barrier dressing (Acticoat* ) applied immediately post-procedure is effective in reducing the incidence of infection. The objective of this study was to assess when it is appropriate to use an antimicrobial barrier dressing rather than a post-operative film dressing, by evaluating the net cost and budget impact of the two strategies.
METHODS: An economic model was developed, which estimates expected expenditure on dressings and the expected costs of surgical site infection during the initial inpatient episode, based on published literature on the pre-discharge costs of surgical infection and the efficacy of an antimicrobial barrier dressing in preventing SSI.
RESULTS: At an SSI risk of 10%, an antimicrobial barrier dressing strategy is cost neutral if the incidence of infection is reduced by at least 9% compared with a post-operative film dressing. At 35% efficacy, expenditure on dressings would be higher by £30,760 per 1000 patients, and the cost of treating infection would be lower by £111,650, resulting in a net cost saving of £80,890. The break-even infection risk for cost neutrality is 2.6%.
LIMITATIONS: Although this cost analysis is based on published data, there are limitations in methodology: the model is dependent on and subject to the limitations of the data used to populate it. Further studies would be useful to increase the robustness of the conclusions, particularly in a broader range of surgical specialties.
CONCLUSIONS: A strategy involving the use of an antimicrobial barrier dressing in patients at moderate (5-10%) or high (>10%) risk of infection appears reasonable and cost saving in light of the available clinical evidence.
Authors:
David Leaper; Jameel Nazir; Chris Roberts; Richard Searle
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of medical economics     Volume:  13     ISSN:  1941-837X     ISO Abbreviation:  J Med Econ     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9892255     Medline TA:  J Med Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  447-52     Citation Subset:  IM    
Affiliation:
Department of Wound Healing, Cardiff University, Cardiff, Wales, UK. profdavidleaper@doctors.org.uk
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