Our Summary

This research paper analyzes the cost-effectiveness of using a special technique known as Closed-Incision Negative Pressure Therapy (CINPT) with the Prevena system in a specific type of vascular surgery involving groin incisions. The surgery is called femoral-popliteal bypass, and it’s often performed with a prosthetic graft.

The researchers compared the outcomes and costs of surgeries with and without the use of CINPT, considering both successful surgeries and those with post-surgery complications. They used a type of analysis that looks at the cost of different strategies in relation to their effectiveness, and they set a threshold of $50,000 as the amount they’d be willing to pay for a particular health benefit.

Their results show that using CINPT in these surgeries is both less expensive (costing $40,138 versus $41,774) and slightly more effective. This makes it the more cost-effective strategy, even considering the additional cost of the CINPT device. However, if the success rate of the surgery drops below around 85%, or if the cost of CINPT goes over $3,139, then surgery without CINPT becomes more cost-effective.

Overall, they have a high level of confidence (99.07%) in their conclusion that CINPT is a more cost-effective approach for these surgeries.

FAQs

  1. What is Closed-Incision Negative Pressure Therapy (CINPT) and how is it used in femoral-popliteal bypass surgeries?
  2. According to the research, under what conditions does surgery without CINPT become more cost-effective?
  3. What level of confidence do the researchers have in their conclusion that CINPT is a more cost-effective approach for femoral-popliteal bypass surgeries?

Doctor’s Tip

In discussing femoral-popliteal bypass with a patient, a doctor might advise them that using Closed-Incision Negative Pressure Therapy (CINPT) with the Prevena system can be a cost-effective and beneficial option to consider. This technique can help improve outcomes and reduce the risk of post-surgery complications, ultimately leading to better results for the patient. It’s important to weigh the potential benefits of using CINPT against the added cost and determine if it is the right choice for the individual’s specific situation.

Suitable For

Patients who are typically recommended for femoral-popliteal bypass surgery include those with severe peripheral arterial disease (PAD) causing blockages in the femoral and popliteal arteries. These blockages can lead to symptoms such as leg pain, numbness, weakness, and difficulty walking. Patients with critical limb ischemia, where blood flow to the leg is severely compromised, may also be candidates for femoral-popliteal bypass surgery.

Other factors that may make a patient a good candidate for femoral-popliteal bypass surgery include:

  • Failure of conservative treatment options such as medication, exercise, and lifestyle changes
  • Presence of a non-healing wound or ulcer on the leg
  • Severe or worsening symptoms that significantly impact quality of life
  • Lack of other viable treatment options

It is important for patients to undergo a thorough evaluation by a vascular surgeon to determine if femoral-popliteal bypass surgery is the best treatment option for their specific condition. The decision to recommend this type of surgery will take into account the patient’s overall health, the severity of their PAD, and their individual risk factors for surgery.

Timeline

Before femoral-popliteal bypass surgery, a patient may experience symptoms such as leg pain, numbness, or weakness due to reduced blood flow in the leg arteries. They may undergo diagnostic tests such as an angiogram to evaluate the blockage in the arteries and determine if surgery is necessary.

During the surgery, a prosthetic graft is used to create a bypass around the blocked artery, restoring blood flow to the leg. The incision is made in the groin area, which can be at risk for post-surgery complications such as infection or wound dehiscence.

After the surgery, the patient may experience pain, swelling, and bruising in the leg. They will be monitored closely for signs of complications and may need to follow a rehabilitation program to regain strength and mobility in the leg.

With the use of CINPT with the Prevena system, the incision site is treated with negative pressure therapy to promote healing and reduce the risk of infection. This technique has been shown to be more cost-effective compared to surgeries without CINPT, as it reduces the overall cost of care and improves outcomes for patients undergoing femoral-popliteal bypass surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about femoral-popliteal bypass surgery with Closed-Incision Negative Pressure Therapy (CINPT) include:

  1. What is the success rate of femoral-popliteal bypass surgeries with CINPT compared to those without?

  2. What are the potential complications or risks associated with using CINPT in this surgery?

  3. How does the cost of using CINPT in the surgery compare to the cost of not using it?

  4. Are there any specific criteria or factors that would make me a better candidate for CINPT in this surgery?

  5. What is the threshold for the cost-effectiveness of using CINPT in femoral-popliteal bypass surgery, and how does that affect my individual situation?

  6. How confident are you in the conclusion that CINPT is a more cost-effective approach for this surgery, based on the research findings?

  7. Are there any alternative techniques or treatments that could be considered for this surgery, and how do they compare in terms of cost-effectiveness and effectiveness?

  8. Can you provide more information about the Prevena system and how it is used in conjunction with CINPT for femoral-popliteal bypass surgery?

  9. What is the recovery process like for patients who undergo femoral-popliteal bypass surgery with CINPT, and how does it differ from traditional surgery without CINPT?

  10. Are there any specific steps I should take before and after the surgery to optimize the benefits of using CINPT in my case?

Reference

Authors: Bloom JA, Tian T, Homsy C, Singhal D, Salehi P, Chatterjee A. Journal: Am Surg. 2023 Jun;89(6):2237-2246. doi: 10.1177/00031348221087395. Epub 2022 Apr 7. PMID: 35392664