Wounds. 2025 Oct;37(10):409-416.
ABSTRACT
BACKGROUND: Negative pressure wound therapy with instillation and dwell time (NPWTi-d) provides repeated wound cleansing plus the therapeutic benefits of traditional NPWT and has been elevated to a first-line therapy in some regions given evidence of its effectiveness.
OBJECTIVE: To examine the effect of NPWTi-d on health care utilization and costs in South Africa, where NPWTi-d may still be used as a therapy of last resort.
METHODS: This retrospective study was conducted utilizing a large, South African, private health insurance claims database. A matched cohort of 836 inpatients receiving NPWTi-d or NPWT for various wound types from 2018 through 2022 was created using propensity scoring. Differences in outcomes were compared between groups using t tests.
RESULTS: Despite matching, patients who received NPWTi-d were likely more complex than those who received NPWT, as indicated by a longer length of stay (18.5 days and 13.2 days, respectively; P < .001) and higher overall care costs during the index hospital admission. Readmission rates were similar between groups; however, patients who received NPWTi-d were less likely to have visits for wound-related subacute care or rehabilitation (20.1% vs 53.6%). The average cost of this care (in South African rand) was significantly lower for patients receiving NPWTi-d than for those receiving NPWT (R3 231 and R12 317, respectively; P < .001).
CONCLUSION: Although this study had limitations, including a potential selection bias, study data suggest that NPWTi-d may reduce wound-related health care utilization and costs for some patients through decreases in visits for subacute care. More studies are needed to fully assess how NPWTi-d affects wound care pathways, patient outcomes, and costs in South Africa.
PMID:41270202
