Role of customised negative-pressure wound therapy in the integration of split-thickness skin grafts: A randomised control study

Mohsin, Mir; Zargar, Haroon Rashid; Wani, Abrar Ahad; Zaroo, Mohammad Inam; Baba, Peerzada Umar Farooq; Bashir, Sheikh Adil; Rasool, Altaf; Bijli, Akram Hussain

doi:10.4103/ijps.ijps_196_16

Cited by 23 publications

(18 citation statements)

References 32 publications

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“…In addition, excess fluid between tissues may be further extracted, thus reducing tissue edema, promoting local blood circulation and facilitating wound healing. A previous study has indicated that VSD may promote wound healing in OT and improve the survival rate of transplanted skin (6). In the present study, VSD was used for the treatment of patients with OT.…”

Section: Effects Of Vacuum Sealing Drainage To Improve the Therapeutimentioning

confidence: 86%

Effects of vacuum sealing drainage to improve the therapeutic effect in patients with orthopedic trauma and to reduce post‑operative infection and lower‑limb deep venous thrombosis

Zhang

Zhao

et al. 2020

Exp Ther Med

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The present study investigated the effects of vacuum sealing drainage (VSD) to improve the therapeutic efficacy in patients with orthopedic trauma (OT) and reduce post-operative infection and lower-limb deep venous thrombosis (DVT) through a retrospective analysis. A total of 76 patients with OT treated at our hospital were selected for observation. The patients were divided into the control group (CG; n=37) and the experimental group (EG; n=39) according to the treatment administered. For patients in the CG, routine dressing changes were applied. Patients in the EG underwent VSD treatment. The dressing change frequency, time between the first and second operation, hospital stay, treatment efficacy, wound healing time, interleukin-6 (IL-6) serum level, tumor necrosis factor-α (TNF-α) serum level, incidence of post-operative infection and incidence of lower-limb DVT were compared between the two groups. The dressing change frequency in the EG was less than that in the CG. The time between the first and second operation and hospital stay were shorter in the EG than in the CG (P<0.05). The total effective rate in the EG was 97.44%, which was higher than that in the CG (78.38%; P<0.05). The wound healing time in the EG was 1.72±0.73 weeks and shorter than that in the CG (2.23±0.85 weeks; P<0.05). With the progression of treatment, the serum IL-6 and TNF-α levels decreased in the two groups, but the levels in the EG were lower than those in the CG (P<0.05). The incidence of post-operative infection and lower-limb venous thrombosis in the EG were 7.69 and 0.00%, respectively, and lower than those in the CG (27.03 and 13.01%, respectively; P<0.05). In the treatment of OT, VSD may reduce the dressing change frequency, shorten the operation time and hospital stay, accelerate wound healing and reduce post-operative infection and lower-limb DVT. Thus, the VSD treatment method is worthy of promotion and implementation in clinic.

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Section: Effects Of Vacuum Sealing Drainage To Improve the Therapeutimentioning

confidence: 86%

Effects of vacuum sealing drainage to improve the therapeutic effect in patients with orthopedic trauma and to reduce post‑operative infection and lower‑limb deep venous thrombosis

Zhang

Zhao

et al. 2020

Exp Ther Med

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“…Although the survival rate of the grafts was improved and operative time was reduced using NPC in this study, given the expense, it may not be cost‐effectiveness to apply for all skin graft patients. Therefore, we suggest that NPC may be most useful in patients with large or muscle‐exposing defects.…”

Section: Discussionmentioning

confidence: 88%

Negative‐pressure closure was superior to tie‐over technique for stabilization of split‐thickness skin graft in large or muscle‐exposing defects: A retrospective study

Nakamura

Fujisawa

Ishitsuka

et al. 2018

The Journal of Dermatology

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Skin grafts are frequently used for the reconstruction of skin defects, and optimal stabilization of the graft is essential for successful reconstruction. Although the tie-over technique has been widely used as a standard method in Japan, we sometimes encounter cases with significant graft loss due to suboptimal stabilization of the graft. Reported risk factors for increased graft loss include the following: defects of a large size, with muscle exposure, and located in the trunk and extremities. Recent studies have demonstrated the usefulness of negative-pressure closure (NPC) for the stabilization of skin grafts due to the uniform pressure it provides across the graft. Therefore, since March 2017, we have used NPC for skin graft stabilization in patients with defects in the trunk and extremities of more than 10 cm in size or with muscle exposure. We carried out a retrospective comparative study of the outcome of the conventional tie-over technique versus NPC. Mann-Whitney U-test revealed that NPC showed significantly higher graft survival rate than tie-over method (P = 0.0012). In addition, NPC showed a tendency toward shorter operative times (from skin graft harvest to the completion of the graft stabilization) than the tie-over method (P = 0.0931). These results suggest that NPC may be superior to the tie-over method for stabilization of skin grafts especially in large or muscle-exposing defects in the trunk or extremities.

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“…which showed maximum hospital stay of 22 days in the traditional wound dressing and the 9 days in the negative pressure dressing group with a statistically significant p-value. They also discovered the impact of this on the cost of care which they found to be 22 times more in the traditional wound dressing group while using a locally adapted negative wound dressing method [ 10 ]. It was also discovered by Petkar et al .…”

Section: Discussionmentioning

confidence: 99%

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

Maduba¹,

Nnadozie²,

Modekwe³

et al. 2020

PAMJ

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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.

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Role of customised negative-pressure wound therapy in the integration of split-thickness skin grafts: A randomised control study

Cited by 23 publications

References 32 publications

Effects of vacuum sealing drainage to improve the therapeutic effect in patients with orthopedic trauma and to reduce post‑operative infection and lower‑limb deep venous thrombosis

Effects of vacuum sealing drainage to improve the therapeutic effect in patients with orthopedic trauma and to reduce post‑operative infection and lower‑limb deep venous thrombosis

Negative‐pressure closure was superior to tie‐over technique for stabilization of split‐thickness skin graft in large or muscle‐exposing defects: A retrospective study

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

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