OBJECTIVES: No method exists for measuring cost-effectiveness of services rendered to patients throughout the continuum of care. Products categorized within the durable medical equipment (DME) benefit add another complicating factor in determining the economic value of therapies. The objective of this study is to determine the cost-effectiveness of V.A.C.® Therapy compared to standard wound treatment for a dehisced chest wound patient treated across the continuum of care. METHODS: Treatment flows were determined through analyses of clinical literature and verified by physicians. An economic model was constructed using data from published literature to determine events and transition probabilities. Publicly available sources were used to determine clinical outcomes, hospital days, nursing time, and costs. A claims database was used for home care information. Meta-analyses served to integrate disparate data sources, (e.g., by calculating weighted averages). RESULTS: The economic model estimated the potential cost savings greater than $8,500 for treating dehisced chest wound patients with V.A.C.® Therapy when compared to wet-to-moist dressings. The return on investment (ROI defined as potential savings divided by material costs for V.A.C.® Therapy,) is calculated to be $6.68: $1. This figure suggests that every dollar spent on V.A.C.® Therapy may be associated with more than $6 potential savings. The largest factor contributing to the cost-effective outcomes of V.A.C.® Therapy was the number of hospital days. V.A.C.® Therapy was associated with an estimated 5.2 fewer days compared to wet-to-moist therapy. The difference in closure method (e.g., primary closure instead of flap, secondary closure instead of primary closure) was the second largest contributor to the model results. CONCLUSIONS: This study suggests that V.A.C.® Therapy for a dehisced chest wound may provide a potential cost savings when compared to wet-to-moist treatments. These results highlight the importance of assessing wound therapy based on cost-effectiveness and ROI rather than on daily DME cost.