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Cutaneous laser surgery for secondary burn reconstruction: Cost benefit analysis
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Thermal disease presents a major burden to individual patient morbidity, healthcare cost as well as to over all economy. Burns also also represent a significant per-patient utlilisation of finite healthcare resources. Secondary complications in these patients, such as multiple drug resistant organisms, may have a devastating effect. Laser surgery has recently come of age as an optimal tool in the secondary reconstruction of burn injury, that is able to simultaneously address significant sheet scar tightness, hypertrophic, atrophic, and keloid complications, pruritus, microstomia, ectropion, skin graft honeycombing, and improve range of movement whilst reducing the risk of infection to1%. Yet, cutaneous laser surgery is often underutilised due to the perceived concerns about the sustainability of a new service with relatively high startup cost. We present a dual methodology to explore this concern: an evidence-based background review of the last 5 years of current best evidence, and a 22-year cost-analysis comparison at an established, high volume UK Centre of reconstructive surgery. We report that fiscal viability for laser surgery services for secondary burn reconstruction is supported by: level 2 (one systematic review) level 4 evidence (2 studies) and level 5 evidence (expert reports). Evidence over 22 years from an established super-regional NHS laser centre shows that introduction of this service led to sustained and substantial cost saving, producing excellent surgical results at a fraction of the cost of traditional surgery. Analysis of the potential dollar-effect of these advantages to the general population supports state investment in expertise and capital equipment as a medium to long-term cost saving strategy, which may also aid re-integrating patients into the workforce making a meaningful contribution to the economy.
- Subjects :
- Laser surgery
Burn injury
medicine.medical_specialty
Contracture
medicine.medical_treatment
Cost-Benefit Analysis
Population
Burn Units
Dermatologic Surgical Procedures
Critical Care and Intensive Care Medicine
State Medicine
Cicatrix
Health care
Medicine
Humans
Intensive care medicine
education
health care economics and organizations
education.field_of_study
Cost–benefit analysis
business.industry
Microstomia
Ectropion
General Medicine
Plastic Surgery Procedures
medicine.disease
United Kingdom
Workforce
Emergency Medicine
Surgery
Laser Therapy
business
Burns
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....5a3a33e549517b4c39b3554ce0865124