Cost of treatment of hard-to-heal wounds in Italy: a study on real-world data

Objective: To assess the clinical effectiveness and cost benefits of negative pressure wound therapy with instillation and dwell (NPWTi-d) compared to standard NPWT and other therapies in managing hard-to-heal wounds. Method: An observational, retrospective, multicentre study was conducted using data from three hospitals in Italy. Eligible patients included all adults discharged in 2021 with specific diagnoses related to hard-to-heal wounds. Data on healthcare resource use, including length of hospital stay (LoS), number of dressings used and procedures performed, were analysed. The economic evaluation estimated hospitalisation costs based on the average daily rate. The analysis findings were further examined in an expert meeting focused on assessing the impact of continuity of care pathways on treatment outcomes. Results: A total of 64 patients were enrolled: 38 received NPWT; 16 received NPWTi-d; and 10 received other treatments, including traditional and advanced wound care approaches. The NPWTi-d group demonstrated a significantly shorter average LoS (13.4 days) compared to the NPWT (23.6 days) and other treatments (21.5 days) groups. Patients receiving NPWTi-d also had fewer dressing changes (2.6) than those treated with NPWT (3.5) and other therapies (6.6). This reduction in resource consumption translates to cost savings of >€6000 (–35.1%) per hospitalisation compared to the overall average hospitalisation cost across the study sample and €7645 (–40.7%) compared to other treatments. The findings were confirmed during the expert meeting. Conclusion: As shown by the findings of this study, by improving patient outcomes and reducing the burden on healthcare systems, NPWTi-d should be considered a key component in modern wound care pathways. Its implementation aligns with current healthcare initiatives focused on optimising resource use and improving patient quality of life.