Petrou S, Parker B, Masters J, et al. - An economic assessment was carried out from the perspective of the United Kingdom NHS and Personal Social Services, on the basis of evidence from the 460 persons in the Wound Management of Open Lower Limb Fractures (WOLLF) trial in order to estimate the cost-efficiency of negative-pressure wound therapy (NPWT) compared with standard wound management following primary surgical wound debridement in adults with severe open fractures of the lower limb. The base case analysis yielded an incremental cost-efficiency ratio of £267,910 per QALY gained, highlighting higher costs on average and just marginally greater QALYS in the NPWT group. In this patient population, irrespective of the value of the cost-effectiveness threshold, the probability that NPWT is cost-efficient did not surpass 27%. This result remained strong to several sensitivity and subgroup analyses. Therefore, this trial-based economic assessment implies that for enhancing outcomes in adult persons with severe open fractures of the lower limb, NPWT is unlikely to be a cost-efficient approach.