A prospective randomized controlled trial comparing negative pressure dressing and conventional dressing methods on split-thickness skin grafts in burned patients

Petkar, Kiran; Dhanraj, Prema; Kingsly, Paul M.; Sreekar, Harinatha; Lakshmanarao, Aravind; Lamba, Shashank; Shetty, Rahul; Zachariah, Jewel Raj

doi:10.1016/j.burns.2011.05.013

Cited by 116 publications

(84 citation statements)

References 9 publications

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“…Nevertheless, split-skin take was rather high when using TNP. These findings are in accordance with the outcome in nondiabetic burn patients 12,13 and may be explained by the reduction of hematoma and seroma and better graft fixation on the wound bed with reduced shear stress. 19 Different factors can delay the wound healing process.…”

Section: Discussionsupporting

confidence: 91%

“…8,9,11 It is known that topical negative pressure (TNP) dressings alias negative pressure wound therapy can increase graft take rate, even in burned patients. 12,13 However, the effectiveness of TNP on grafts in diabetic patients with foot scalds has never been reported. Therefore, we compared the outcome of antiseptic dressing with a circular TNP dressing on the freshly laid split-thickness skin graft (SSG) after tangential excision in insulin-dependent diabetes mellitus (IDDM) patients after deep dermal scald of the foot (Figures 1 and 2).…”

Section: Introductionmentioning

confidence: 98%

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Reduced Amputation Rate by Circular TNP Application on Split-Skin Grafts After Deep Dermal Foot Scalds in Insulin-Dependent Diabetic Patients

Kisch

Liodaki

Mauss

et al. 2015

Journal of Burn Care & Research

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The incidence of insulin-dependent diabetes mellitus (IDDM) is expected to increase significantly. Due to peripheral neuropathy and angiopathy in IDDM patients, feet scalding results in deep burn injuries. Regularly amputations are needed with tremendous consequences. In relatively healthy patients, split-skin graft (SSG) take is better when topical negative pressure (TNP) is applied. We compared the outcome of circular TNP dressing with that of antiseptic dressing on freshly laid SSG after tangential excision in IDDM patients with deep dermal foot scalds. Seventy patients admitted to a burn center with isolated foot burns were identified (2008-2013). Ten of them suffered from IDDM and presented with a deep dermal foot scald. After tangential excision and split-skin grafting, five of them were treated with TNP. The others received an antiseptic dressing regime. Differences were analyzed using either Chi-square or Student's t-test. Group comparison regarding age, gender, body mass index, HbA1c on arrival, glucose in serum, IDDM disease duration, and TBSA revealed no significant differences. But percentage of graft take was at a significantly higher rate in the TNP group (90.2 ± 4.017 vs 39 ± 15.362) and fewer operations had to be performed compared to the control group (2.0 ± 0.447 vs 4.6 ± 0.927). Due to reduced occurrence of necrosis, the number of amputations required was significantly lower in the TNP group. TNP application on freshly laid SSG following tangential excision in IDDM patients after deep dermal foot scalds minimized amputation rates and therefore is of great benefit for such patients.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 98%

Reduced Amputation Rate by Circular TNP Application on Split-Skin Grafts After Deep Dermal Foot Scalds in Insulin-Dependent Diabetic Patients

Kisch

Liodaki

Mauss

et al. 2015

Journal of Burn Care & Research

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“…On the other hand, NPWT can stimulate the healing of the wound, reduce inflammatory stimulus to the wound, and alleviate local pain for patients [26,27]. Cro C et al have shown that negative pressure draining can stimulate more growth of new blood vessels and significantly increases wound blood flow by improving the microcirculation [8,28,29].…”

Section: Discussionmentioning

confidence: 98%

Using negative pressure wound therapy on microskin autograft wounds

Zhang

Qiu

et al. 2015

Journal of Surgical Research

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“…Its application to split and full-thickness skin grafts is of particular relevance to dermatologic surgery. Several randomized controlled trials [5][6][7] have been conducted that reveal statistically significant improvement in not only graft take but also graft appearance with the use of NPWT when compared with traditional bolster dressings. These results are not surprising when considering the VAC's mechanism of action and the common reasons for skin graft failure.…”

Section: Negative-pressure Wound Therapymentioning

confidence: 98%