The effect of timing of instillation therapy on outcomes and costs for patients receiving negative pressure wound therapy.

ABSTRACT

INTRODUCTION: Although NPWTi-d has been associated with improved patient outcomes compared with NPWT alone, questions remain regarding the timing of NPWTi-d initiation. OBJECTIVE: This study examined the effect of the timing of NPWTi-d initiation on patient outcomes and costs. METHODS: A retrospective analysis was conducted utilizing a national, all-payer hospital database and included patients who received NPWTi-d in 2019. A matched cohort of 514 patients who received either early (within 1 day of NPWT application) or late (within 2-7 days of NPWT application) NPWTi-d initiation was created using propensity scoring. Differences in clinical outcomes and costs were compared using Wilcoxon rank sum, chi-square, and t tests. RESULTS: Early NPWTi-d initiation was associated with significantly shorter NPWT duration (7.0 vs. 11.4 days; P <.0001) and inpatient stay (13.4 vs. 16.3 days; P <.0001) compared with late NPWTi-d initiation. Early NPWTi-d initiation was also associated with fewer debridements, OR visits during hospitalization, days until final OR procedure, and wound-related readmissions. Patients with early NPWTi-d initiation had a $10 877 lower mean cost of index admission (P <.0001), which included lower NPWT costs. CONCLUSION: Study data suggest that in these patients with wounds, early NPWTi-d initiation helped improve patient outcomes and reduced care costs.