Clinical outcomes after negative-pressure wound therapy (NPWT) and standard treatment of conflict-related extremity wounds are similar. In resource-limited settings, cost affects the choice of treatment. We aimed to estimate treatment-related costs of NPWT in comparison with standard treatment for conflict-related extremity wounds. We derived outcome data from a randomized, controlled superiority trial that enrolled adult (≥ 18 years) patients with acute (≤ 72 h) conflict-related extremity wounds at two civilian hospitals in Jordan and Iraq. Primary endpoint was mean treatment-related healthcare costs (adjusted to 2019 US dollars). Patients were enrolled from June 9, 2015, to October 24, 2018. A total of 165 patients (155 men [93.9%]; 10 women [6.1%]; and median [IQR] age, 28 [21–34] years) were included in the analysis. The cost per patient treated with NPWT was $142 above that of standard treatment. Overall, results were robust in a sensitivity analysis. With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings. Trial registration NCT02444598.

中文翻译：

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一项随机对照试验中负压伤口治疗与标准治疗急性冲突相关肢体伤口的成本分析

负压伤口治疗 (NPWT) 和冲突相关肢体伤口的标准治疗后的临床结果相似。在资源有限的情况下，成本会影响治疗的选择。我们的目的是估算 NPWT 的治疗相关费用，并与冲突相关四肢伤口的标准治疗进行比较。我们从一项随机对照优势试验中获得结果数据，该试验在约旦和伊拉克的两家民用医院招募了患有急性（≤ 72 小时）冲突相关肢体伤口的成人（≥ 18 岁）患者。主要终点是与治疗相关的平均医疗保健费用（调整为 2019 美元）。患者于 2015 年 6 月 9 日至 2018 年 10 月 24 日入组。共有 165 名患者（155 名男性 [93.9%]；10 名女性 [6.1%]；中位 [IQR] 年龄，28 [21-34] 岁）被纳入分析。接受 NPWT 治疗的每位患者的费用比标准治疗高出 142 美元。总体而言，敏感性分析的结果是稳健的。与标准护理相比，临床结果相似，我们的结果不支持在资源稀缺环境中的平民医院使用 NPWT 常规治疗与冲突相关的四肢伤口。试用注册NCT02444598。