OBJECTIVES: Wound complications following surgical procedures are a significant cost burden to the health care system and have been identified as one of the hospital-acquired infections not reimbursed by payers. Surgical site infections have been associated with both an increased hospital stay of 9.58 extra days and $38,656 in additional medical charges, and postoperative dehiscence can add as much as 9.42 extra days, resulting in $40,323 in additional charges.  A health economic model was developed to demonstrate potential cost savings associated with using closed incision management (CIM*) to apply negative pressure wound therapy (NPWT) over clean closed surgical incisions in patients treated for an open fracture of the tibia and fibula.   METHODS: The hypothetical economic model applied national cost dollars to clinical outcomes of the Stannard et al randomized controlled trial (RCT) using NPWT† over closed incisions. National cost data (Thomson Reuters custom report) were selected using the diagnosis codes related to the population of patients within the Stannard et al RCT, which were open fracture of the tibia and fibula with complications such as infection and dehiscence (ICD9 79.36). The infection rates (10%, 14/141 patients NPWT and 19%, 23/122 patients Control [standard of care], p=0.049) and dehiscence rates (8.6%, 12/141 NPWT and 16.5%, 20/122 Control, p=0.044) were calculated from the Stannard et al RCT and were applied to a hypothetical 100 patient population (50 CIM and 50 Control). RESULTS: Reduced infection and dehiscence rates in this patient population resulted in potential per patient cost savings of $5338 for infection and $1586 for dehiscence with CIM. CONCLUSIONS: These findings illustrate the potential cost effectiveness of CIM over closed incisions of high-risk fractures.  *Prevena™ Incision Management System and †V.A.C. Therapy; KCI USA, Inc., San Antonio, TX, USA