Comparing hospital stay and patient satisfaction in a resource poor setting using conventional and locally adapted negative pressure wound dressing methods in management of leg ulcers with split skin grafts: a comparative prospective study

Abstract

Introduction chronic leg ulcers cause a prolonged hospital stay with devastating effects on the patients. Several modifiable factors are taken care of to reduce the duration of stay. A further measure to hasten wound bed preparation pre-grafting and to hasten graft healing post-grafting is with negative pressure dressing. Methods sixty-two patients were placed in two groups of 31 cases each. The wound beds were prepared with negative pressure apparatus locally adapted with suction machine for group A and with conventional gauze dressing using 5% povidone iodine soaks for group B. Grafted wound was also dressed similarly for the respective groups. Grafts were inspected on the 5 th post-operative day and were determined with planimeter grid. Grafts were monitored until completely healed and patients were discharged. Satisfaction and length of stay were determined at discharge. Results the mean hospital stay pre-grafting and post-grafting were 12.2 (±8.64) days and 13.6 (±2.03) days respectively for the negative pressure dressing and 28.8 (±30.9) days and 21.8 (±21.97) days respectively for the traditional dressing group. These differences with p values of 0.038 for the pre-grafting stay and 0.006 for the post-grafting stay were statistically significant. The patients managed with negative pressure dressing also recorded greater satisfaction with the process and the outcome. Conclusion negative pressure dressing contributes significantly to reducing the length of hospital stay in chronic leg ulcers both in wound bed preparation and in graft healing resulting to better patient satisfaction than in patients treated with conventional gauze dressing and 5% povidone iodine soaks.

Wound Bed Preparation using Nonsurgical Methods: A Prospective Comparative Study of Honey versus Unripe Papaya (Carica papaya)

“…This achieves the goal of reduced length of hospital stay and easing of admission burden in the limited hospital facility in the resource poor setting. [ 18 ] This is aimed at reducing the financial stress on the economically constrained patients who pay out of pocket due to poorly developed health insurance program in the developing nations. [ 19 , 20 ] This option of wound bed preparation brought overwhelming satisfaction on the patients due to significant reduction in the length of hospital stay.…”

Wound Bed Preparation Using Unripe Pawpaw in a Resource Poor Environment: A Prospective Study

“…We employed the use of unripe pawpaw dressing to achieve an earlier wound bed preparation. Although use of negative pressure wound dressing has been found to cause both earlier wound bed preparation and better skin graft take in the long run, it is applicable and preferable in wounds debrided of dead tissues 12 , 13 . This is where unripe pawpaw dressing has its unique application.…”

A bioreactor for studying negative pressure wound therapy on skin grafts

“…While traditionally used when treating open wounds, NPWT is increasingly being used for closed wounds, fluid management, and as an adjunct to improve skin graft adherence of both meshed and sheet grafts. NPWT has been shown to lead to decreased graft failure rates, 2‐14 decreased hospital stay, 3,15 reduced reoperation rate, 8 and a decreased number of complications, 12‐14 along with increased patient satisfaction 15,16 . While frequently implemented for wound care in the paediatric population, additional studies are still warranted to establish standard treatment guidelines 17 .…”