OBJECTIVES: Lower extremity ulcers such as venous leg ulcers (VLU) and diabetic foot ulcers (DFU) have a major impact on quality of life and continue to impose a substantial cost burden on healthcare providers.[i] NPWT is known to be an effective treatment for these wound types, and the development of single-use portable canisterless NPWT (sNPWT) has provided smaller, lighter devices for patients and their caregivers. The purpose of this study was to determine the cost-effectiveness of sNPWT compared with traditional NPWT (tNPWT) for the treatment of lower extremity ulcers in the USA. METHODS: A decision-analytic model was constructed; the model type was a two-state Markov model with a cycle length of one week and a time horizon of 26 weeks. The measure of incremental effectiveness was the number of open ulcer weeks avoided. Comparative data on the effectiveness of the two alternatives, along with relevant cost data, were used to populate the model. The perspective of the model was the US payer. One-way sensitivity analysis and threshold analysis were also conducted. RESULTS: The portable canister-free single-use NPWT was found to be dominant, being both cost saving and more effective than traditional NPWT. Switching to sNPWT would result in an expected cost saving of $14,273 per patient and an expected reduction of 5.31 open ulcer weeks per patient. The threshold analysis indicated that cost-neutrality occurred at a daily tNPWT cost of $41.32, around $15 less than the daily cost for sNPWT. Above this value, with all other inputs unchanged, sNPWT is expected to be cost-saving compared with tNPWT. CONCLUSIONS: This analysis suggests that for appropriate lower extremity ulcers, treatment with single-use NPWT is more cost-effective than traditional NPWT, and that sNPWT should be considered as the preferred alternative to traditional NPWT.