Author(s)
Rachel Regone, MD
Tyler McElwee
N. Eddie Liou, MD
Affiliation(s)
Baylor College of Medicine, Bobby R. Alford Department of Otolaryngology Head & Neck Surgery
Abstract:
To compare the cost-effectiveness of the Erich arch bar and Synthes matrixWAVE (WAVE) systems at a tertiary, level 1 trauma center. Retrospective chart review. The charts of 454 patients who underwent maxillomandibular fixation (MMF) between January 2015 and January 2016 were reviewed. Cases were excluded if additional procedures other than open reduction internal fixation (ORIF) were performed or if there was incomplete documentation, for instance, if time of procedure was not recorded. Thirty-six cases met criteria and were stratified according to the operating service (either otolaryngology, oral maxillofacial surgery, or plastic surgery) and the number and type of ORIF completed with MMF. Twenty-three patients underwent MMF with Erich arch bars and 13 with the WAVE. On average the WAVE decreased operative time by just over 24 minutes. In our hospital system each minute in the operating room costs an average of $15.77. The WAVE system costs between $1000-1200, while Erich arch bars cost $31. Complications included post-operative infections or abscess formation in patients who did not take prescribed antibiotics—three in the Erich group (13%) and one in the WAVE group (7%). There was no significant difference between the complication rates of the two systems. Although the application of the WAVE system resulted in less operative time than the Erich arch bar system, the average savings on time per case (a little under $400) is not enough to offset the overall cost of the WAVE system. Erich arch bars are more cost-effective than the Synthes matrixWAVE system.