Justifying Additional Staff Using the Cost-Effectiveness of Noncontact Low-Frequency Ultrasound* Therapy in a Long-Term Acute-Care Setting

Noncontact low-frequency ultrasound (NLFU)* has been shown to increase proportion of wounds healed, volume reduction, and healing rate relative to conventional wound therapies alone.^1-5 Therefore, we evaluated the cost benefit of NLFU to justify adding additional staff to administer NLFU to more patients in a long-term acute-care (LTAC) setting.

Five consecutive patients with wounds suitable for treatment with NPWT or NFLU were treated with NLFU. Actual costs of therapy with NLFU plus topicals and dressings were compared to standard costs for NPWT (pump rental, dressings, and canisters). Patient 1 had full thickness surgical wounds of the ischium (4.2 cm²) and left trochanter (22.1 cm²). After 4 weeks of NLFU, ischium was closed and trochanter area was 0.9 cm². Patient 2 had a sacrococcygeal Stage IV pressure ulcer (147.6 cm³) with osteomyelitis, undermining, and 50% slough. Wound volume decreased to 22.3 cm³ and 100% granulation with 7 weeks of NLFU. Patient 3 had a Stage IV pressure ulcer of the right buttock (63 cm³) with extensive undermining and 50% slough. Wound volume decreased to 50.4 cm³ with greatly reduced undermining and 15% slough after 12 days of NLFU. Patient 4 had a surgical wound from left great toe amputation (27.7 cm³) with 50% slough. Wound volume decreased to 3.9 cm³ with 30% slough after 12 days of NLFU. Patient 5 had a sacrococcygeal Stage IV pressure ulcer (42.1 cm³). Wound volume decreased to 25.6 cm³ with 5 weeks of NLFU. Patient’s sitting tolerance for dialysis increased from 0 to 5 hours. Per-patient cost savings ranged from $1267 to $2653. Full case reports and per-patient cost analyses will be presented.

NLFU was a cost-saving alternative to NPWT in surgical wounds and pressure ulcers. The cost savings provided justification for adding additional staff to administer NLFU treatments to more patients within our LTAC.