**Objective:** Low-frequency ultrasound debridement with irrigation is an effective method of wound bed preparation.A recent clinical study compared hypochlorous acid preserved wound cleanser (HAPWOC) to saline and found HAPWOC to be a more effective adjunct to low frequency ultrasound debridement.However, HAPWOC has an added cost.The primary objective of this study was to assess the cost-effectiveness of HAPWOC as an Store gift cards irrigation modality with low-frequency ultrasound debridement for the treatment of severely complex wounds that were destined to be closed primarily via a flap.
The secondary objective of this study was to estimate the number needed to treat (NNT) to avoid a wound-related complication and its expected cost per NNT.**Methods:** A patient-level Monte-Carlo simulation model was used to conduct a cost-effectiveness analysis from the US health system perspective.All clinical data were obtained from a prospective clinical trial.Cost data were obtained from the publicly available data sources in 2021 US dollars.
The effect measure was the avoidance of wound-related complications at 14-days post-debridement.The primary outcome was the incremental cost-effectiveness ratio (ICER), a measure of the additional cost per benefit.The secondary outcomes were the NNT and expected cost per NNT to avoid one complication (complementary to the ICER in assessing cost-effectiveness).Deterministic and probabilistic sensitivity analyses (PSA) were performed to gauge the robustness and reliability of the results.
**Results:** The ICER for HAPWOC versus saline irrigation was US$90.85 per wound complication avoided.The expected incremental cost per patient in the study and effect was US$49.97 with 55% relative reduction in wound-related complications at day 14 post debridement procedure.
The NNT and cost per NNT were 2 and US$99.94, respectively.Sensitivity analyses demonstrated that these results Watch Case + Bands were robust to variation in model parameters.**Conclusion:** HAPWOC was a cost-effective strategy for the treatment of complex wounds during ultrasonic debridement.
For every two patients treated with HAPWOC, one complication was avoided.