Cost analysis of XXXX -impregnated collagen sponges in preventing sternal wound infection post cardiac surgery.

@entity1 @entity801
OBJECTIVE: The use of antibiotic-impregnated sponges (Collatamp) during cardiac surgery is controversial. We analysed the cost-effectiveness of its selective use in @entity1 at high-risk of sternal wound infection (SWI). METHOD: Postoperative costs were analysed in two groups of @entity1 undergoing heart surgery between 2011 and 2013: those with SWI (group 1) and in high-risk @entity1 without SWI (group 2). The potential cost of @entity801 -impregnated collagen sponges (GCS) use in high-risk @entity1 was compared with our current practice. RESULTS: We identified 1,251 @entity1 with at least one recognised risk factor for developing SWI in this period. Of these, 18 developed SWI (incidence 1.4%). The median postoperative cost per @entity1 without SWI was   9,617. The additional cost per @entity1 incurred by SWI was   4,860.75. The annual additional cost for treating @entity1 with SWI was   43,749. With a 50% reduction in SWI, the annual additional cost of treating these @entity1 would be reduced to   21,873. The cost of GCS is   80 per @entity1 . Adding this to   21,873 gives a potential total cost of   71,913 in the treated high-risk cohort. CONCLUSION: In our practice the annual cost of treating SWI in high-risk @entity1 without use of GCS is lower than the annual cost of using GCS in all high-risk @entity1 (  43,749 versus   71,913) if it produces a 50% reduction in SWI. The reduction in the incidence of SWI poses no economic benefit when the cost of the product is factored in.
