Reverse Aqua Pump Negative Pressure Wound Therapy: A Noninferiority Randomized Controlled Trial of Effectiveness and Affordability in Optimizing the Inflammatory and Proliferative Phases of Wound Healing in Developing Countries.

Purpose: Negative pressure wound treatment (NPWT) has been proven effective in accelerating wound healing. However, its high cost limits its use in developing countries, and innovations have largely focused on supplementary rather than core system components. The reverse aqua pump (RAP)-NPWT was developed as a low-cost alternative with effectiveness equivalent to commercial NPWT. This study aims to assess clinical outcomes and analyze the costs of using RAP-NPWT in patients requiring further reconstruction wounds with skin grafts. Methods: A noninferiority randomized controlled trial design comparing RAP-NPWT with commercial NPWT through comparative outcome, correlation analysis, and cost evaluation. A total of 24 subjects (12 RAP-NPWT and 12 NPWT control) were analyzed with no significant differences in baseline characteristics. Results: No significant difference was found in the degree of granulation from the first day to the end of treatment. Bone exposure did not affect granulation development, and the duration of NPWT use between groups did not differ. Economically, RAP-NPWT showed significantly lower treatment costs with a negative incremental cost-effectiveness ratio and cost-minimization analysis, placing it as the dominant intervention that is both more cost effective. Conclusions: Overall, RAP-NPWT provides noninferior clinical efficacy to commercial NPWT but at a significantly lower cost, making it worthy of consideration as a more affordable solution in developing countries. Type of study/level of evidence: Randomized controlled trial IB.