OBJECTIVES: Surgical site infections (SSIs) are a common and costly complication, increasing readmission rates, length of hospitalization, mortality, and resulting in overall costs of $3.3 billion to the US healthcare system. Triclosan-coated sutures (TCS) have been demonstrated to reduce the risk of SSI, and large global health authorities recommend their use. The objective of this study was to conduct a budget impact analysis comparing TCS to traditional non-coated sutures (NCS) using the US hospital perspective.

METHODS: An economic model was developed to evaluate the impact of TCS use in the US. Current treatment practices assumed use of NCS, while future practice assumed 50% NCS and 50% TCS use. Each procedure was assumed to require 3 suture units. Surgery types were broken down into clean, clean-contaminated, and contaminated-dirty wounds per CDC definition. NCS and TCS SSI rates by wound type were calculated using data from a systematic review and meta-analysis by Leaper and colleagues. The average of cost per NCS strand and SSI episode were taken from the literature and inflated to 2018 USD. Results were calculated as costs per patient and population, assuming a hypothetical cohort of 2,000. Sensitivity analyses using conservative estimates for the reductions in the risk of SSIs with TCS were also conducted.

RESULTS: The analysis predicted introduction of TCS in the future practice could result in savings of $554.25 per patient due to avoided SSIs. This translated into a potential savings of $1,108,490 when considering a population of 2,000 procedures. Results of the sensitivity analyses estimated savings for all scenarios tested.

CONCLUSIONS: Based on the results of this analysis, the increased upfront additional costs of TCS is minimal in comparison to the estimated cost savings from reduced risk of infections versus NCS. TCS should be considered as part of the comprehensive approach for hospitals to address the risk of SSI.