Toman J, Adams JR, Choi M, Mason D, Hubbs BS, Forsyth RA, Rogers GS, et al.
Journal of drugs in dermatology : JDD. Date of publication 2025 May 1;volume 24(5):450-456.
1. J Drugs Dermatol. 2025 May 1;24(5):450-456. doi: 10.36849/JDD.8436.
Placental Allograft Reconstruction of Cutaneous Wounds Following Mohs Surgery: A
Propensity Score-Matched Comparative Cost-Effectiveness Analysis.
Toman J, Adams JR, Choi M, Mason D, Hubbs BS, Forsyth RA, Rogers GS.
BACKGROUND: The purpose of this study was to examine the cost-effectiveness of
placental allograft as a nonoperative surrogate to autologous tissue-based
methods of defect reconstruction on the face, head, and dorsal hand following
Mohs micrographic surgery (MMS).
METHODS: This study was a 5-year retrospective, analysis comparing
propensity-matched cohorts of eligible Mohs surgery patients treated with a
placental allograft (dHACM, dehydrated human amnion/chorion membrane) vs
autologous tissue-based repairs. Costs on day 0 through discharge were used for
a cost-effectiveness analysis (CEA) and an incremental cost-effectiveness ratio
(ICER).
RESULTS: Four-hundred-twenty-nine propensity-matched patients meeting the
entry/exclusion criteria were divided into treatment (dHACM) and Standard of
Care (SOC) cohorts in a 1:2 match. The study population was 78.8% male, with a
mean age of 77.8 ± 9.3 years. The primary reconstruction cost increased
with dHACM (P<.0001), while the cumulative cost of care was similar between
groups (P>0.05). MMS defects treated with dHACM had significantly lower rates
of adverse post-repair sequelae; infection (P=0.0114), dehiscence (P=0.0189),
necrosis (P=0.0349), hematoma (P=0.0066) and scar revisions (P=0.0044),
resulting in an average savings of $409.55 for high-risk post-MMS defects and a
dominant ICER.
CONCLUSION: In subjects meeting the entry/exclusion criteria, closure of
post-MMS defects with dHACM resulted in significantly lower rates of adverse
post-repair sequelae (2.8% vs 21.3%, P<.0001), which offset the upfront cost
of dHACM, resulting in shorter lengths of care and favorable cosmetic outcomes.
dHACM may be a cost-effective approach for surgical wounds in select patient
populations.
CITATION: Toman J, Adams JR, Choi M, et al. Placental allograft reconstruction
of cutaneous wounds following Mohs surgery: a propensity score-matched
comparative cost-effectiveness analysis. J Drugs Dermatol. 2025;24(5):450-456.
doi:10.36849/JDD.8436.
DOI: 10.36849/JDD.8436
PMID: 40327580 [Indexed for MEDLINE]
