Incisional Negative Pressure Wound Therapy devices applied after Total Ankle Arthroplasty: A Hospital-Based Health Technology Assessment
Jamal Atfeh, Pascale Guerre, Emmanuelle Carre, Jean-Luc Besse, Laure Huot
Abstract
A portable, single-use incisional Negative Pressure Wound Therapy (iNPWT) device could be used directly on the wound incision following Total Ankle Arthroplasty (TAA). In order to support local decision-making in a French university hospital for the adoption of such device in this indication.
Introduction
Total Ankle Arthroplasty (TAA) is an orthopedic surgical procedure known for its rare but severe postoperative complications. In the early post-operative period, these complications are mostly wound healing problems [1–4] which can lead to Surgical Site Infections (SSI) with incidence between 1.2% and 3.3% according literature [2,4,5].
Materials and Methods
The HB-HTA included three dimensions that have a direct impact on deciding whether to introduce a new medical device at the hospital level.
Results
Nine citations were identified from the literature search. A review of titles and abstracts, and full texts when needed, excluded seven citations that did not fulfill the inclusion criteria: one was an expert opinion on the potential benefit of iNPWT in TAA published in 2010.
Discussion
To our knowledge, this is the first HB-HTA report evaluating clinical, economic and organizational dimensions of a portable single-use iNPWT device applied prophylactically on closed incisions following TAA. It relied also on the first economic evaluation based on a RCT available in this indication.
Acknowledgments
The authors would also like to thank the contribution of Lea Ponce (Hospices Civils de Lyon, Pôle de Santé Publique, Service d’Evaluation Economique en Santé) for English proofreading, and Stéphanie Vicente (Hospices Civils de Lyon, Pôle de Santé Publique, Service Recherche et Epidémiologie Cliniques) for her help in coordinating the PICO-PTC study.
Citation: Atfeh J, Guerre P, Carre E, Besse J-L, Huot L (2025) Incisional Negative Pressure Wound Therapy devices applied after Total Ankle Arthroplasty: A Hospital-Based Health Technology Assessment. PLoS One 20(4): e0322327. https://doi.org/10.1371/journal.pone.0322327
Editor: Nan Jiang, Southern Medical University Nanfang Hospital, CHINA
Received: May 21, 2024; Accepted: March 18, 2025; Published: April 29, 2025
Copyright: © 2025 Atfeh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the article and its Supporting Information files.
Funding: The PICO-PTC study was sponsored by the Hospices Civils de Lyon and funded by a grant from Smith&Nephew (Investigator Initiated study grant). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No authors received salary from the funder.
Competing interests: The authors have declared that no competing interests exist.
