Presentation (CTI)

OBJECTIVES: Wound closure methods can influence rates of wound complications, which are associated with morbidity and costs. Clinical and US economic studies indicated that multi-layer watertight closure (MLWC) with STRATAFIX™ Knotless Tissue Control Devices and DERMABOND® PRINEO® Skin Closure System reduced delayed healing, reoperations, hospital stay, and healthcare costs. This study evaluates the financial and environmental impact of implementing MLWC versus conventional closure (CC) in the UK setting.
METHODS: A budget and environmental impact analysis was undertaken to compare MLWC solution to CC in total joint arthroplasty. A decision tree model estimated the total costs and climate impact for a cohort of 100 patients. Costs were estimated from the UK hospital perspective and climate impact was estimated using a carbon dioxide equivalent metric (CO2-eq). Inputs were sourced from real-world data, NHS England tariffs and published literature. Each analysis examined the impact of devices and linked healthcare resource use on costs and CO₂e. Deterministic and probabilistic sensitivity analyses (DSA and PSA) were conducted.
RESULTS: MLWC generated a cost saving of £424.32 and reduced emissions by 47 kg CO₂e per patient. DSA indicated that results were most sensitive to the length-of-stay with CC, the extent of length-of-stay reduction achieved with MLWC, as well as cost of the length-of-stay. PSA showed mean (95% CrI) cost savings of £424 (£364-£490) and a reduction of 47 kg (41-54) CO₂e per patient.
CONCLUSIONS: To our knowledge, along with the results in the Spanish setting, this is the first study to quantify the environmental footprint of MLWC and the first to evaluate its economic impact in a European context. In the UK, the MLWC may offer cost savings and a reduced carbon footprint compared with CC in total arthroplasty.