Economic Value Of Using Antimicrobial Coated Sutures For Abdominal Incisions To Prevent Surgical Site Infections

Since surgical site infections (SSI) continue to impose a substantial burden to hospital and society, there is a need to evaluate newer SSI-prevention interventions such as antimicrobial (e.g., triclosan) coated sutures. We developed a decision analytic model using TreeAge Pro to determine the cost-effectiveness of antimicrobial sutures in abdominal incisions from the hospital, third party payer, and societal perspectives. Sensitivity analyses systematically varied the risk of developing an SSI (range: 5% - 20%), cost of triclosan-coated sutures (range: $5 - $25 per inch), and efficacy of triclosan-coated sutures to prevent infection (range: 5% - 50%). Depending on their efficacy, triclosan-coated sutures saved $4,109 – 13,975 (from the hospital perspective), $4,133 – 14,297 (third party payer), and $40,127 – 53,244 (societal) per SSI prevented, when a surgery had a 15% SSI risk. However, if the SSI risk after surgery was ≤5% and the efficacy in preventing SSIs was ≤10%, triclosan-coated sutures resulted in extra expenditure for hospitals and third party payers; resulting in extra costs of $1,626 and $1,071 per SSI prevented for hospitals and third party payers respectively, if SSI risk was 5% and efficacy was 10%. Our results show that switching to triclosan-coated sutures from the uncoated sutures can prevent SSIs and save substantial costs to hospitals, third party payers, and society over a wide range of SSI prevention efficacy, cost, and risk values.