title: Cost study of dermal substitutes and topical negative pressure in the surgical treatment of burns.
abstract: BACKGROUND
  A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment.
  
  
  METHODS
  The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity.
  
  
  RESULTS
  Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP (p=0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 (p<0.001). However, mean total costs per patient did not differ significantly between groups (range €29097-€43774).
  
  
  CONCLUSIONS
  Costs of the interventional treatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role.
authors.affiliation: Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M Jenda
authors.initials: MJ
authors.lastname: Hop
authors.affiliation: Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Monica C T
authors.initials: MC
authors.lastname: Bloemen
authors.affiliation: Association of Dutch Burn Centres, Maasstad Hospital, Rotterdam, The Netherlands. Electronic address: baarm@maasstadziekenhuis.nl.
authors.forename: Margriet E
authors.initials: ME
authors.lastname: van Baar
authors.affiliation: Association of Dutch Burn Centres, Martini Hospital, Groningen, The Netherlands.
authors.forename: Marianne K
authors.initials: MK
authors.lastname: Nieuwenhuis
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands; Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands; Department of Plastic, Reconstructive and Hand Surgery, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Paul P M
authors.initials: PP
authors.lastname: van Zuijlen
authors.affiliation: Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Polinder
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, MOVE Research Institute, VU University Medical Center, Amsterdam, The Netherlands; Association of Dutch Burn Centres, Red Cross Hospital, Beverwijk, The Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Middelkoop
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000191:economics / Q000601:surgery*; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics*; D016038:Skin Transplantation / Q000191:economics*; D017768:Skin, Artificial / Q000191:economics*; D055815:Young Adult
keywords: Burns; Costs; Dermal substitutes; Topical negative pressure