Economic Analysis of AbClo, a Novel Abdominal Fascia Closure Device, for Patients With an Open Abdomen Following Trauma or Acute Abdominal Surgery.

IF 1.2 4区 医学 Q3 SURGERY
Surgical Innovation Pub Date : 2024-06-01 Epub Date: 2024-02-27 DOI:10.1177/15533506241236745
Derek S Chew, Taranvir Dayal
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引用次数: 0

Abstract

Background: Open Abdomen (OA) cases represent a significant surgical and resource challenge. AbClo is a novel non-invasive abdominal fascial closure device that engages lateral components of the abdominal wall muscles to support gradual approximation of the fascia and reduce the fascial gap. The study objective was to assess the economic implications of AbClo compared to negative pressure wound therapy (NPWT) alone on OA management.

Methods: We conducted a cost-minimization analysis using a decision tree comparing the use of the AbClo device to NPWT alone among patients with midline laparotomy for trauma or acute abdominal surgery who were ineligible for primary fascial closure. The time horizon was limited to the length of the inpatient hospital stay, and costs were considered from the perspective of the US Medicare payer. Clinical effectiveness data for AbClo was obtained from a randomized clinical trial. Cost data was obtained from the published literature. Probabilistic and deterministic sensitivity analyses were performed. The primary outcome was incremental cost.

Results: The mean cumulative costs per patient were $76 582 for those treated with NPWT alone and $70,582 for those in the group treated with the AbClo device. Compared to NPWT alone, AbClo was associated with lower incremental costs of -$6012 (95% CI -$19 449 to +$1996). The probability that AbClo was cost-savings compared to NPWT alone was 94%.

Conclusions: The use of AbClo is an economically attractive strategy for management of OA in in patients with midline laparotomy for trauma or acute abdominal surgery who were ineligible for primary fascial closure.

针对创伤或急性腹部手术后开腹患者的新型腹部筋膜闭合装置 AbClo 的经济性分析。
背景:开腹(OA)病例是一项重大的手术和资源挑战。AbClo 是一种新型的非侵入性腹部筋膜闭合装置,它能使腹壁肌肉的外侧部分参与支持筋膜的逐渐逼近并减少筋膜间隙。研究目的是评估 AbClo 与单纯负压伤口疗法 (NPWT) 相比对 OA 管理的经济影响:我们使用决策树进行了一项成本最小化分析,比较了在因外伤或急腹症手术而接受中线开腹手术且不符合初级筋膜闭合条件的患者中使用 AbClo 设备与单纯 NPWT 的效果。时间范围仅限于住院时间,成本则从美国医疗保险支付方的角度考虑。AbClo 的临床有效性数据来自随机临床试验。成本数据来自已发表的文献。进行了概率和确定性敏感性分析。主要结果是增量成本:每位患者的平均累计成本为:仅接受 NPWT 治疗的患者为 76,582 美元,接受 AbClo 设备治疗的患者为 70,582 美元。与单纯 NPWT 相比,AbClo 的增量成本较低,为-6012 美元(95% CI -19 449 美元至+1996 美元)。与单独使用 NPWT 相比,AbClo 可节约成本的概率为 94%:对于因外伤或急腹症手术而接受中线开腹手术但不符合初级筋膜闭合条件的患者而言,使用 AbClo 是一种具有经济吸引力的治疗 OA 的策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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