Cost-Effectiveness of Electrical Stimulation Therapy in the Treatment of Chronic Wounds: A Systematic Review, Meta-Analysis and Economic Analysis

Hard-to-heal wounds are a major burden to healthcare systems. Electrical stimulation therapy (EST) is known to improve clinical outcomes, but cost-effectiveness analysis is lacking. The aim was to explore the cost-effectiveness of EST with standard of care (SoC) versus SoC alone. A systematic review and meta-analysis of randomised controlled studies (RCTs) were conducted. Fourteen RCTs were identified, representing 783 patients. EST + SoC, versus SoC alone, significantly increased the proportion of wounds healed (odds ratio [OR] 2.46 [95% CI, 1.75-3.46], <i>p</i> < 0.0001) and significantly decreased the mean time to healing (-2.67 weeks (95% CI, 1.49-3.84, <i>p</i> < 0.00001). A cost-effectiveness model was developed based on these findings and on the usage and cost of the EST device used in the largest included RCT. Weekly costs of community wound care were taken from published estimates and inflated to 2024 levels, reflecting costs in the UK. In a hypothetical cohort of 100 patients treated over 12 weeks, EST + SoC was estimated to save over GBP 38,000 overall, reduce nursing visits by 385 and lead to 154 more ulcer-free weeks. In conclusion, EST used in the community is a cost-effective addition to SoC with the ability to improve outcomes and reduce human and financial burden of hard-to-heal wounds.