Presentation (CTI)

OBJECTIVES: Surgical site infection (SSI) remains a postoperative complication associated with increased treatment costs and prolonged hospital stay in Thailand and worldwide. However, evidence on the budget impact of promoting antimicrobial-coated sutures is limited. This study aimed to evaluate the potential budget impact of adopting chlorhexidine-coated sutures in an illustrative Thai setting.
METHODS: A one-year decision-analytic cost comparison was developed for 100 hypothetical surgical patients in Thailand. Model inputs included device costs of chlorhexidine-coated sutures and uncoated sutures, SSI rates, SSI management costs per episode, and excess hospital days per SSI event, based on published literature and local market inputs for appendectomy and cholecystectomy patients in Thailand. Outcomes included total annual costs, per-patient costs, and hospital bed days saved. One-way sensitivity analysis varied key parameters by 25%.
RESULTS: Total costs, including device acquisition and SSI management, were THB 175,534.6 with chlorhexidine-coated sutures and THB 279,113.8 with standard sutures, corresponding to annual savings of THB 103,579.2 and a 37.1% reduction in total costs. Per-patient costs were THB 1,755.3 versus THB 2,791.1, yielding savings of THB 1,035.8 per patient. Excess bed days decreased from 48.8 to 29.6, corresponding to 19.2 hospital bed days saved annually. Results were most sensitive to SSI rates, while cost savings remained consistent across tested ranges.
CONCLUSIONS: In this Thai modeling analysis, the higher acquisition cost of chlorhexidine-coated sutures was offset by lower expected SSI-related costs and reduced hospital bed utilization compared with standard sutures. These findings suggest potential hospital-level economic value in appendectomy and cholecystectomy procedures, although results depend on local infection rates, costs, and practices.