OBJECTIVES: Chronic pressure ulcers are a significant health problem for patients in long-term-care facilities. The value of restoring quality of life following a pressure ulcer injury has attracted new treatments. Non-contact normothermic wound therapy (NNWT) (Warm-Up therapy) is a semi-occlusive, moisture retentive wound cover ($240/wound cover/ 2 days) that is warmed to 38oC to promote healing. The goal of this study was to examine the incremental cost-effectiveness of NNWT relative to the current standard of care for treatment of stage III and IV pressure ulcers. METHODS: A Markov cost-effectiveness, computer-simulation model with hypothetical patients was created. The base case involved a 72-year-old man, living in a nursing home, with a stage III ischial pressure ulcer. Standard care was assumed to include moisture retentive dressings, a pressure reducing surface, repositioning, and debridement. RESULTS: Our modeling predicted the total expected cost of standard care treatment for a stage 3 pressure ulcer to be $20,874. Randomized clinical trials have found that NNWT (n = 72 patients) decreases the surface area of stage 3-4 pressure ulcers by 2.5 fold (SD 59%) over standard care (n = 59 patients). The eight-week healing rates for stage 3 ulcers are 71% with NNWT and 54% for standard care. At these healing rates, our modeling for stage 3 pressure ulcers found that for a 40 month time frame NNWT saves $6,630 (SE $98) and increases QALYs by 0.10 (SE 0.0005) life years compared to standard care. For stage 4 pressure ulcers, NNWT saves $15,216(SE $186) and increases QALYs by 0.14 (SE 0.001). CONCLUSIONS: NNWT in patients with stage III and IV pressure ulcer is an economically attractive intervention. Additional well-controlled clinical trials are necessary to further define the role of NNWT in the care of chronic wounds.