{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T23:48:49Z","timestamp":1780616929961,"version":"3.54.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,4,11]],"date-time":"2021-04-11T00:00:00Z","timestamp":1618099200000},"content-version":"vor","delay-in-days":41,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Single-use negative-pressure wound therapy (sNPWT) has been reported to reduce the incidence of reconstruction failure in prepectoral breast reconstruction compared with standard surgical dressings. The aim of this economic evaluation was to investigate the cost-effectiveness of sNPWT compared with standard care for the prevention of reconstruction failure in prepectoral breast reconstruction in the UK.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A decision tree model was used to estimate the expected cost and effectiveness per patient. Effectiveness was measured both by the number of reconstruction failures avoided and the gain in quality-adjusted life-years (QALYs). The baseline incidence of reconstruction failure (8.6 per cent) was taken from a recently published study of 2655 mastectomies in the UK. The effectiveness of sNPWT used results from a clinical study comparing sNPWT with standard dressings. Previously published utility weights were applied. The cost of reconstruction failure was estimated from detailed resource data from patients with reconstruction failure, applying National Health Service reference costs. One-way, probabilistic, scenario and threshold analyses were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The undiscounted cost per patient associated with reconstruction failure was estimated to be \u00a323 628 (\u00a322 431 discounted). The use of sNPWT was associated with an expected cost saving of \u00a31706 per patient, an expected increase in QALYs of 0.0187 and an expected 0.0834 reconstruction failures avoided. Cost-effectiveness acceptability analysis demonstrated that, at a threshold of \u00a320 000 per QALY, 99.94 per cent of the simulations showed sNPWT to be more cost-effective than standard care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Among patients undergoing immediate prepectoral breast reconstruction, the use of sNPWT is more cost-effective than standard dressings.<\/jats:p><\/jats:sec>","DOI":"10.1093\/bjsopen\/zraa042","type":"journal-article","created":{"date-parts":[[2021,4,11]],"date-time":"2021-04-11T11:43:01Z","timestamp":1618141381000},"source":"Crossref","is-referenced-by-count":7,"title":["Cost-effectiveness of single-use negative-pressure therapy compared with standard care for prevention of reconstruction failure in prepectoral breast reconstruction"],"prefix":"10.1093","volume":"5","author":[{"given":"J A","family":"Murphy","sequence":"first","affiliation":[{"name":"Nightingale Breast Unit, Manchester University NHS Foundation Trusts, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Myers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Trueman","sequence":"additional","affiliation":[{"name":"Smith and Nephew , Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3095-5898","authenticated-orcid":false,"given":"R","family":"Searle","sequence":"additional","affiliation":[{"name":"Smith and Nephew , Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,11]]},"reference":[{"key":"2023020209380082200_zraa042-B1","author":"Cancer Research UK. Breast Cancer Incidence (Invasive) Statistics"},{"key":"2023020209380082200_zraa042-B2","author":"Office for National Statistics. Cancer Registration Statistics","year":"2017"},{"key":"2023020209380082200_zraa042-B3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1308\/rcsann.2019.0101","article-title":"Reconstructive utilisation and outcomes following mastectomy surgery in women with breast cancer treated in England","volume":"102","author":"Jeevan","year":"2020","journal-title":"Ann R Coll Surg Engl"},{"key":"2023020209380082200_zraa042-B4","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1002\/bjs.11383","article-title":"Mastectomy Decisions Audit (MasDA) Collaborative, on behalf of the West Midlands Research Collaborative. Multicentre prospective observational study evaluating recommendations for mastectomy by multidisciplinary teams","volume":"107","year":"2020","journal-title":"Br J Surg"},{"key":"2023020209380082200_zraa042-B5","author":"National Cancer Registration and Analysis Service","year":"2015"},{"key":"2023020209380082200_zraa042-B6","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1038\/s41416-019-0438-1","article-title":"iBRA-2 Steering Group; Breast Reconstruction Research Collaborative. The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study","volume":"120","author":"O'Connell","year":"2019","journal-title":"Br J Cancer"},{"key":"2023020209380082200_zraa042-B7","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/PRS.0000000000004270","article-title":"A prospective comparison of short-term outcomes of subpectoral and prepectoral strattice-based immediate breast reconstruction","volume":"141","author":"Baker","year":"2018","journal-title":"Plast Reconstr Surg"},{"key":"2023020209380082200_zraa042-B8","doi-asserted-by":"crossref","first-page":"e1488","DOI":"10.1097\/GOX.0000000000001488","article-title":"Prepectoral implant-based breast reconstruction","volume":"5","author":"Highton","year":"2017","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2023020209380082200_zraa042-B9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.2147\/BCTT.S97764","article-title":"Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions","volume":"8","author":"Ooi","year":"2016","journal-title":"Breast Cancer Targets Ther"},{"key":"2023020209380082200_zraa042-B10","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/PRS.0b013e3182361fd6","article-title":"A meta-analysis of human acellular dermis and submuscular tissue expander breast reconstruction","volume":"129","author":"Kim","year":"2012","journal-title":"Plast Reconstr Surg"},{"key":"2023020209380082200_zraa042-B11","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/S1470-2045(18)30781-2","article-title":"Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study","volume":"20","author":"Potter","year":"2019","journal-title":"Lancet Oncol"},{"key":"2023020209380082200_zraa042-B12","doi-asserted-by":"crossref","first-page":"320","DOI":"10.4103\/2347-9264.169494","article-title":"Cost-effectiveness of one-stage versus two-stage breast reconstruction in the United Kingdom","volume":"2","author":"Teo","year":"2015","journal-title":"Plast Aesthet Res"},{"key":"2023020209380082200_zraa042-B13","doi-asserted-by":"crossref","first-page":"e2667","DOI":"10.1097\/GOX.0000000000002667","article-title":"Negative pressure wound therapy reduces wound breakdown and implant loss in prepectoral breast reconstruction","volume":"8","author":"Irwin","year":"2020","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2023020209380082200_zraa042-B14","doi-asserted-by":"crossref","first-page":"510e","DOI":"10.1097\/01.prs.0000479935.92904.a3","article-title":"Cost-effectiveness analysis of breast reconstruction options in the setting of postmastectomy radiotherapy using the BREAST-Q","volume":"137","author":"Razdan","year":"2016","journal-title":"Plast Reconstr Surg"},{"key":"2023020209380082200_zraa042-B15","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1089\/sur.2017.156","article-title":"Meta-analysis of comparative trials evaluating a prophylactic single-use negative pressure wound therapy system for the prevention of surgical site complications","volume":"18","author":"Strugala","year":"2017","journal-title":"Surg Infect (Larchmt)"},{"key":"2023020209380082200_zraa042-B16","author":"National Institute for Health and Care Excellence","year":"2019"},{"key":"2023020209380082200_zraa042-B17","doi-asserted-by":"crossref","first-page":"e1560","DOI":"10.1097\/GOX.0000000000001560","article-title":"Incisional negative pressure wound therapy for prevention of wound healing complications following reduction mammaplasty","volume":"6","author":"Galiano","year":"2018","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"2023020209380082200_zraa042-B18","doi-asserted-by":"crossref","first-page":"276e","DOI":"10.1097\/PRS.0000000000005194","article-title":"Cost-effectiveness analysis of silicone versus saline implant-based breast reconstruction using the BREAST-Q","volume":"143","author":"Siotos","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"2023020209380082200_zraa042-B19","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/1471-0528.15573","article-title":"Cost-effectiveness of incisional negative pressure wound therapy compared with standard care after caesarean section in obese women: a trial-based economic evaluation","volume":"126","author":"Hyldig","year":"2019","journal-title":"BJOG"},{"key":"2023020209380082200_zraa042-B20","author":"NHS.","year":"2020"},{"key":"2023020209380082200_zraa042-B21","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1586\/erp.10.65","article-title":"Health-state utility values in breast cancer","volume":"10","author":"Peasgood","year":"2010","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"2023020209380082200_zraa042-B22","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1245\/s10434-019-07160-x","article-title":"A systematic review of utility score assessments in the breast surgery cost-analysis literature","volume":"26","author":"Yoon","year":"2019","journal-title":"Ann Surg Oncol"},{"key":"2023020209380082200_zraa042-B23","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.bjps.2013.12.035","article-title":"The cost effectiveness of acellular dermal matrix in expander\u2013implant immediate breast reconstruction","volume":"67","author":"Krishnan","year":"2014","journal-title":"J Plast Reconstr Aesthet Surg"},{"key":"2023020209380082200_zraa042-B24","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.ejso.2016.09.019","article-title":"National trends in immediate and delayed post-mastectomy reconstruction procedures in England: a seven-year population-based cohort study","volume":"43","author":"Mennie","year":"2017","journal-title":"Eur J Surg Oncol"},{"key":"2023020209380082200_zraa042-B25","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198526629.001.0001","volume-title":"Decision Modelling for Health Economic Evaluation","author":"Briggs","year":"2006"},{"key":"2023020209380082200_zraa042-B26","author":"Association of Breast Surgery, British Association of Plastic Reconstructive and Aesthetic Surgeons","year":"2012"}],"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/5\/2\/zraa042\/49044203\/zraa042.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/5\/2\/zraa042\/49044203\/zraa042.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T23:20:02Z","timestamp":1698880802000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zraa042\/6220255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,3,5]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zraa042","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3]]},"published":{"date-parts":[[2021,3]]},"article-number":"zraa042"}}