Authors' objectives: To assess the effectiveness, safety and cost-effectiveness of negative pressure wound therapy (NPWT) as a treatment modality for acute and chronic wounds.

Authors' results and conclusions: Based on retrievable evidence, the use of NPWT may potentially reduce the risk of surgical site infections and wound dehishence in closed surgical wounds across range of surgical procedures. The NPWT is associated with better wound healing in comparison with standard wound care across different type of wounds except for lower limb open fracture wounds. The NPWT is considered a safe treatment. Treatment related adverse events includes allergic skin reaction and skin blister, which are comparable to standard wound care. Serious adverse events like bleeding, infection, injuries and death are rare. They are mostly associated with unsafe use of NPWT. Evidence from economic evaluation studies tend to suggest that NPWT is likely to be cost saving treatment in the management of wound, particularly in high risk patients with BMI ≥ 35 and severe systemic disease. Based on economic analysis, the use of NPWT in surgical patient will incur additional cost to the healthcare system yielded an ICER between MYR3,300 to MYR 34,000 per SSI averted. However, there may be a potential of more cost savings from societal perspective which may improve the cost effectiveness of NPWT.

Authors' recommendations: Based on current evidence, NPWT may be used as adjunctive treatment for wound management in selected group of patients with high risk of wound complications and delayed wound healing. Access to this treatment in a resource limited setting can be improved by a careful selection of patient, as this will ensure the optimal benefit of NPWT as an alternative option for wound management. In ensuring safe use of NPWT, there should a best practice guideline and the therapy should be administered by certified healthcare providers.

Authors' methods: Part A: Systematic review - A comprehensive search was conducted on the following databases without any restriction on publication language and publication status. The Ovid interface: Ovid MEDLINE(R) ALL <1946 to May 22, 2023>; EBM Reviews - Cochrane Database of Systematic Reviews <2005 to May 16, 2023>; EBM Reviews - NHS Economic Evaluation Database <1st Quarter 2016>. Searches were also run in PubMed. Google was used to search for additional web-based materials and information. Additional articles were identified from reviewing the references of retrieved articles. Last search was conducted on 22 May 2023. Part B: Economic evaluation - A decision tree was developed in Microsoft Excel to estimate the expected costs and health outcomes associated with the use of NPWT and standard of care in reducing surgical site infection. The base case analysis provides the expected cost and outcome when the intervention was given to adult patients who undergone surgeries. The analysis was conducted using the healthcare provider perspective and considers a short-term time horizon on the basis that surgical complications may occur relatively soon after surgery.

Authors' identified further research: -

Project Status: Completed

Year Published: 2023

URL for published report: https://www.moh.gov.my/index.php/database_stores/store_view_page/30/404

Requestor: Decision-making committee

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment Section (MaHTAS)