Split Skin Graft Take in Leg Ulcers: Conventional Dressing Versus Locally Adapted Negative Pressure Dressing

Maduba, Charles Chidiebele; Nnadozie, Ugochukwu Uzodimma; Modekwe, Victor Ifeanyichukwu; Onah, Ifeanyichukwu Igwilo

doi:10.1016/j.jss.2020.01.029

Cited by 15 publications

(21 citation statements)

References 7 publications

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“…Recently, there have been some reviews comparing with the conventional method and the negative pressure fixation. Yin et al reported that the negative pressure fixation group had an average of 7.02% better rate of graft take than the conventional method, and there are other similar reports [9][10][11] . The following causes are considered as factors for improving skin graft engraftment.…”

Section: Discussionmentioning

confidence: 85%

A Case of Extensive Necrotizing Fasciitis with Poor General Condition Treated by Gradual Debridement and Postage Stamp Skin Graft Bolstered with Negative Pressure Wound Therapy at the Bedside

Kasai

Kiuchi

Ihara

et al. 2021

International Journal of Surgical Wound Care

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Case presentation69-year-old female. Based on untreated diabetes, she was hospitalized for necrotizing fasciitis of the right thigh from the lower abdomen (Fig. 1a). She was in shock due to sepsis, but antibiotics improved her inflammation, and she withdrew from the shock. Subsequently, debridement was performed. However, since she had a cerebral infarction when shock and treatment under general anesthesia were at high risk, bedside debridement was performed daily under local anesthesia (Fig. 1b). Eight days after the start of debridement, most of the necrotic tissue was resected. Still, extensive skin defect of 35 ×

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Section: Discussionmentioning

confidence: 85%

A Case of Extensive Necrotizing Fasciitis with Poor General Condition Treated by Gradual Debridement and Postage Stamp Skin Graft Bolstered with Negative Pressure Wound Therapy at the Bedside

Kasai

Kiuchi

Ihara

et al. 2021

International Journal of Surgical Wound Care

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“…2,17 Third, negative-pressure wound therapy can move fluid away from the wound base, thus promoting microcirculatory flow and stimulating angiogenesis. 2,18 In low-mobility areas, skin graft take rates were similar between the groups. Moisidis et al 11 showed that no quantitative difference was found in a randomized controlled trial between negativepressure wound therapy and tie-over bolster dressing for split-thickness skin grafting.…”

Section: Plastic and Reconstructive Surgery • December 2022mentioning

confidence: 80%

“…2,17 Third, negative-pressure wound therapy can move fluid away from the wound base, thus promoting microcirculatory flow and stimulating angiogenesis. 2,18…”

Section: Discussionmentioning

confidence: 99%

Negative pressure wound therapy improves take rate of skin graft in irregular, high-mobility areas compared to Tie-over Bolster Dressings: A Randomized Controlled Trial

Cao¹,

Hu²,

Zhang³

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Tie-over bolster dressing to secure a skin graft is associated with low graft take rates in irregular, high-mobility areas and suboptimal recipient wound beds. Negative-pressure wound therapy has become a well-established method to secure the graft, with a graft take rate of this method reported to be 96.7 percent. However, comparative efficacies between the two methods on irregular, high-mobility areas are yet to be determined. Methods: Patients eligible for skin graft were randomly assigned to receive either negative-pressure wound therapy or tie-over bolster dressing between December of 2014 and December of 2015. The primary outcome was determined by the take rate of skin grafts between postoperative days 5 and 7. The secondary outcomes were dressing time and postoperative complications, including hematoma, seroma, infection, displacement, and necrosis. Results: A total of 86 patients were assigned to receive either negative-pressure wound therapy (n = 43) or tie-over bolster dressing (n = 43) for skin graft treatment. Negative-pressure wound therapy significantly improved the take rate of grafts as compared with tie-over bolster dressing (97.2 versus 90.2 percent; p = 0.005). The improvements came from the grafts in irregular, high-mobility areas in the respective groups (97.6 versus 81.7 percent; p < 0.001). Negative-pressure wound therapy reduced skin graft displacement as a postoperative complication as compared with tie-over bolster dressing (one versus nine patients; p = 0.007). Dressing time using negative-pressure wound therapy was significantly shorter compared with tie-over bolster dressing (15.2 ± 4.2 versus 27.4 ± 4.3 minutes; p = 0.001). Conclusion: Negative-pressure wound therapy can improve the take rate of skin grafts in irregular, high-mobility areas and shorten the dressing time. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Maduba

Nnadozie

Modekwe

et al. 2022

WJPS

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BACKGROUND Chronic wounds affect mainly the productive age group in developing countries and stretch the limited healthcare facility. We aimed to establish the efficacy or otherwise of pawpaw dressing in management of common forms of wounds in resource-poor settings using the Nigerian pawpaw in humans. METHODS This study was a prospective research carried out at Alex Ekwueme Federal University Teaching Hospital Abakaliki Nigeria between September 2019 and August 2020 using patients with lower extremity wounds. Thirty patients who had lower extremity wounds that required debridement were enrolled in the study after giving consent. They had wound dressing with unripe pawpaw as an enzymatic debriding agent to evaluate the rapidity of eschar separation and bacterial clearance. The data obtained with a proforma were analyzed using IBM SPSS. RESULTS There were 16 males and 14 females with an average wound size of 127.13+ 103cm2. Eschar separation occurred earliest after 3 d of dressing and the latest after 14 d with a mean period of 5.5+ 2.255 days. A case had negative bacterial culture on the first test. Others had a variable period of clearance with a maximum of 18 d and a mean of 6.73+3.750 days. Both eschar separation and bacterial clearance correlated positively with the wound size. CONCLUSION Wound bed preparation with unripe pawpaw dressing showed promising outcomes with rapid eschar and slough separation, and bacterial clearance resulting in a faster wound healing. This is recommended for wounds needing debridement in which the patients are not fit for anesthesia or could not afford the cost of surgery.

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Split Skin Graft Take in Leg Ulcers: Conventional Dressing Versus Locally Adapted Negative Pressure Dressing

Cited by 15 publications

References 7 publications

A Case of Extensive Necrotizing Fasciitis with Poor General Condition Treated by Gradual Debridement and Postage Stamp Skin Graft Bolstered with Negative Pressure Wound Therapy at the Bedside

A Case of Extensive Necrotizing Fasciitis with Poor General Condition Treated by Gradual Debridement and Postage Stamp Skin Graft Bolstered with Negative Pressure Wound Therapy at the Bedside

Negative pressure wound therapy improves take rate of skin graft in irregular, high-mobility areas compared to Tie-over Bolster Dressings: A Randomized Controlled Trial

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

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