Outcomes of skin graft reconstructions with the use of Vacuum Assisted Closure (VAC®) dressing for irradiated extremity sarcoma defects

Senchenkov, Alex; Petty, Paul M.; Knoetgen, James; Moran, Steven L.; Johnson, C. H.; Clay, Ricky P.

doi:10.1186/1477-7819-5-138

Cited by 41 publications

(35 citation statements)

References 31 publications

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“…32 In the recent literature, only a few references are available on the use of NPWT after resection of musculoskeletal tumors. 5,[33][34][35] All of these studies have evidenced the effectiveness of negative pressure-assisted wound healing. The reported complications rate, the rate of infection, and the length of hospitalization were significantly lower compared with traditional treatment.…”

Section: A 67-year-old Woman With Ependymoma Of the Sacrum And Lumbarmentioning

confidence: 98%

Negative-Pressure Wound Therapy for Musculoskeletal Tumor Surgery

Sakellariou

Mavrogenis²,

Papagelopoulos³

2011

Advances in Skin &Amp; Wound Care

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Section: A 67-year-old Woman With Ependymoma Of the Sacrum And Lumbarmentioning

confidence: 98%

Negative-Pressure Wound Therapy for Musculoskeletal Tumor Surgery

Sakellariou

Mavrogenis²,

Papagelopoulos³

2011

Advances in Skin &Amp; Wound Care

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“…The latter also reported better and faster engraftment of Integra over exposed bone, joint, tendon and bowel with use of vacuum closure [15]. Alex et al achieved successful graft takes over irradiated beds [16]. Warren et al used a simple suction device that cost far less than the commercial product and yet achieved full graft take in all his nine cases studied [17].…”

Section: Discussionmentioning

confidence: 93%

“…Vacuum closure, has turned out to be to be a good alternative [13][14][15][16][17][18][19][20]. The effects of vacuum closure on a wound bed [26] and on a graft-bed interface are listed in Table 4.…”

Section: Discussionmentioning

confidence: 99%

“…Ever since its inception in early 1990s it has extensively been used and proven beneficial in various clinical settings involving wounds and their management [3][4][5][6][7][8][9][10][11][12]. It's usage over skin graft has been reported and [13][14][15][16][17][18][19][20] and some of the studies have shown encouraging results. However, there are few comparative studies against the conventional dressing technique of skin grafts particularly those which include a variety of aetiologies and graft beds and measure the graft take as a between-group-comparison continuous data.…”

Section: Introductionmentioning

confidence: 97%

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Vacuum closure as a skin-graft dressing: a comparison against conventional dressing

Petkar¹,

Dhanraj²,

Sreekar³

2012

Eur J Plast Surg

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Background Grafting condition is one of the important determinants of skin-graft take. The technique of VacuumClosure has been claimed to improve the same and thereby graft take. However, there are few comparative studies against the conventional dressing technique evaluating its effectiveness in skin grafting. The present study was undertaken to compare Vacuum-closure with conventional dressing over freshly laid split-skin grafts. Methods Consecutive patients undergoing split-skin grafting were randomized into cases and controls. The grafts in controls were covered by a conventional dressing consisting of vaseline gauze and cotton pads. Those in cases were covered by a vacuum-closure assembly and connected to a wall-suction of 80 mm Hg continuously for four days. The percentage of graft take was assessed at nine days and at two weeks and duration of the dressing were compared between the two groups. The difference in cost of the dressing was noted down. Results Sixty four patients underwent split skin grafting of 71 wounds. Forty three of them were males and twenty nine were females. The grafted wounds included fresh surgically created wounds, traumatic wounds, acute and chronic burn wounds, post-inflammatory wounds and diabetic wounds. Thirty five of the grafts were cases and 36 were controls. Final graft take at two weeks in the study group ranged from 70-100 per cent with an average of 95.29 per cent graft take (SD: 5.9) while the control group showed a graft take ranging between 0-100 percent with an average graft take of 85.89 percent (SD: 25.1) Duration of dressing of the grafts was 11.63 days in cases as against 15.11 days in controls. The differences were statistically significant. The additional cost of the vacuum-closure assembly for an average sized ulcer was 6.27 pounds. Conclusion Negative pressure dressing increases the amount of graft take and should be used particularly when the wound bed and grafting conditions seem less-than-ideal for a complete graft take. Negative-pressure dressing can be economically and effectively assembled using locally available materials. Level of Evidence: Level I, therapeutic study.

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“…NPWT combined with STSG are reported effective for irradiated sarcoma defects of the extremities [4], trauma [5], and burn [6]. NPWT followed by reconstructive surgery using the pectoralis major flap and STSG were reported to be successful for wound dehiscence after clamshell incision [7].…”

Section: Discussionmentioning

confidence: 98%