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Updated: Aug 23, 2025
Severe Burn Injury in a Swine Model for Clinical Dressing Assessment
Published on: November 6, 2018
Cost-effectiveness of scar management post-burn: a trial-based economic evaluation of three intervention models
Steven M McPhail1,2, Jodie Wiseman3, Megan Simons3,4,5
1Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Social Work and Public Health, Queensland University of Technology, 149 Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia. steven.mcphail@qut.edu.au.
Insights
Topical silicone gel is the most cost-effective burn scar treatment for children, offering significant savings compared to pressure garments or combined therapies. This approach may be preferred when clinical benefits of other methods are not clearly superior.
Area of Science:
- Pediatric Burn Scar Management
- Health Economics
- Clinical Trials
Background:
- Optimal burn scar management is crucial for pediatric quality of life but resource-intensive.
- Evaluating the cost-effectiveness of different scar treatments is essential for healthcare resource allocation.
Purpose of the Study:
- To compare the cost-effectiveness of three pediatric burn scar management interventions: pressure garment, topical silicone gel, and combined therapy.
- To inform clinical and economic decision-making in pediatric burn scar care.
Main Methods:
- A randomized controlled trial involving 153 children undergoing burn scar management.
- Costing healthcare resource use from a health service perspective over a 6-month post-burn period.
- Analysis of Quality Adjusted Life Year (QALY) estimates and cost-effectiveness probabilities.
Main Results:
- Topical silicone gel had the lowest mean total scar management cost ($382.87) compared to pressure garment ($1327.02) and combined therapy ($1605.97).
- No significant differences in QALYs were observed between the groups.
- Topical silicone gel demonstrated a high probability of dominating both pressure garment (70%) and combined therapy (63%) in terms of cost-effectiveness.
Conclusions:
- Topical silicone gel is a more cost-effective intervention for pediatric burn scar management.
- This intervention may be favored over pressure garment therapy or combination approaches, particularly when clear clinical advantages of other methods are absent.
- The findings support the use of topical silicone gel as a primary, cost-saving strategy in pediatric burn scar care.
Abstract:
Optimal burn scar management has the potential to markedly improve the lives of children, but can require substantial healthcare resources. The study aimed to examine the cost-effectiveness of three scar management interventions: pressure garment; topical silicone gel; combined pressure garment and topical silicone gel therapy, alongside a randomised controlled trial of these interventions. Participants were children (n = 153) referred for burn scar management following grafting, spontaneous healing after acute burn injury, or reconstructive surgery. Healthcare resource use was costed from a health service perspective (6-months post-burn time-horizon). The mean total scar management cost was lowest in the topical silicone gel group ($382.87 (95% CI $337.72, $443.29)) compared to the pressure garment ($1327.02 (95% CI $1081.46, $1659.95)) and combined intervention $1605.97 ($1077.65, $2694.23)) groups. There were no significant between-group differences in Quality Adjusted Life Year estimates. There was a 70% probability that topical silicone gel dominated pressure garment therapy (was cheaper and more effective), a 29% probability that pressure garment therapy dominated combined therapy, and a 63% probability that topical silicone gel dominated combined therapy. In conclusion, topical silicone gel was the cheaper intervention, and may be favoured in the absence of clear clinical effect favouring pressure garment therapy or a combination of these management approaches.Trial registration: ACTRN12616001100482 (prospectively registered).
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