Cost-Effectiveness of Vacuum-Assisted Wound Closure Versus Conventional Dressings for Complex Surgical Wounds in Kano

Vacuum-assisted closure (VAC) therapy has demonstrated superior wound healing rates in complex surgical wounds in high-income settings, but its cost-effectiveness in the Nigerian context has not been rigorously evaluated. This study analyzes the cost-effectiveness of VAC therapy compared to conventional moist wound dressings for complex postoperative wounds at a teaching hospital in Kano State, North West Nigeria, from 2021 to 2023. A prospective randomized controlled trial allocated 80 patients with complex surgical wounds to VAC therapy (n=40) or conventional dressings (n=40). Primary outcomes were wound healing time, number of dressing changes, wound closure rates, and total treatment costs. VAC therapy achieved complete wound closure in significantly fewer days (mean 18 versus 34 days, p<0.001), required fewer dressing changes (mean 8 versus 24), and had lower rates of secondary wound infection (10% versus 30%). Despite higher per-unit device costs, total treatment cost per healed wound was 12% lower in the VAC group when nursing time and consumables were included. The study supports the cost-effectiveness of VAC therapy for complex surgical wounds in the Nigerian context and recommends procurement of VAC devices for tertiary hospitals in North West Nigeria, supported by training and maintenance protocols to ensure sustainable deployment. Keywords: vacuum-assisted closure, wound healing, cost-effectiveness, Kano, complex wounds