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

Petkar, Kiran; Dhanraj, Prema; Sreekar, Harinatha

doi:10.1007/s00238-012-0698-y

Cited by 15 publications

(11 citation statements)

References 24 publications

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“…Four RCTs compared NPWT with traditional methods of graft fixation 58–61 . Llanos et al 60 analyzed 30 burn patients receiving SSGs, comparing NPWT with a control in which the same dressing was applied without connection to negative pressure.…”

Section: Resultsmentioning

confidence: 99%

“…Four RCTs compared NPWT with traditional methods of graft fixation. [58][59][60][61] Llanos et al 60 analyzed 30 burn patients receiving SSGs, comparing NPWT with a control in which the same dressing was applied without connection to negative pressure. There was significantly less skin graft loss in the NPWT cohort by the fourth postoperative day (0 cm 2 vs 4.5 cm 22 ), accompanied by a significantly shorter length of hospital stay.…”

Section: Negative Pressure Dressings Versus Other Fixation Methodsmentioning

confidence: 99%

“…Graft take was significantly higher in the NPWT group at both intervals. 61 There were "some concerns" regarding risk of bias. Randomization was robust, and no patients were lost to follow-up; however, assessment of graft take was undertaken by multiple different unblinded clinicians, and assessment of baseline characteristics was limited.…”

Section: Negative Pressure Dressings Versus Other Fixation Methodsmentioning

confidence: 99%

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Safeguarding Skin Grafts

Patel

Asher²,

Bystrzonowski³

et al. 2021

Ann Plast Surg

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Background Effective skin graft fixation is vital in preventing sheering forces, seroma, and hematoma from compromising graft take. Yet, selecting the ideal technique for securing skin grafts remains a contentious subject, with significant variation in practice existing between surgeons. There is, therefore, benefit to be derived from assessing the literature for evidence-based recommendations to guide the decision-making process. Methods A search of Medline and Embase was performed using appropriate key terms, yielding 419 articles. Reference lists were analyzed. Inclusion and exclusion criteria were composed. Level I to III studies, as defined by the Centre for Evidence-Based Medicine, that compared skin graft fixation methods were analyzed. Rayyan QCRI was used for abstract and title screening. After full text screening, 41 studies were included for qualitative analysis. All included randomized control trials (RCTs) were assessed for risk of bias using the Cochrane Risk-of-Bias 2 (ROB2) tool. Results We identified 4 groups of fixation technique: “tie-over bolster” (TOB), “no TOB,” “adhesive glues,” and “negative pressure wound therapy” (NPWT). Twelve studies compared TOB with no TOB, with no difference in graft take demonstrated. Sixteen studies compared adhesive glues with traditional methods, with no difference in graft take demonstrated. Thirteen studies compared NPWT with traditional methods, with enhanced graft take demonstrated. Risk of bias was deemed low in 1 of 13 RCTs. Conclusions Based on the current evidence, only NPWT is associated with enhanced graft take. However, there is a scarcity of robust level I evidence comparing different fixation techniques, meaning that strong recommendations cannot be made. We propose examples of hypothesis-driven RCTs, in predetermined clinical settings, based on the theoretical benefits of the techniques that would add value to clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Negative Pressure Dressings Versus Other Fixation Methodsmentioning

confidence: 99%

Section: Negative Pressure Dressings Versus Other Fixation Methodsmentioning

confidence: 99%

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Safeguarding Skin Grafts

Patel

Asher²,

Bystrzonowski³

et al. 2021

Ann Plast Surg

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“…The NPWT dressing immobilizes the graft, reducing shear motion and fluid accumulation beneath the graft. Two well-designed and implemented RCTs (total n = 124 grafts) reported a statistically significant improvement in graft take and decreased time to healing 33,34 (Level/Class: A/IIa).…”

Section: Npwt-split-thickness Skin Graftmentioning

confidence: 99%

Wound Healing Devices Brief Vignettes

Anderson

Hare

Perdrizet

2016

Advances in Wound Care

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The demand for wound care therapies is increasing. New wound care products and devices are marketed at a dizzying rate. Practitioners must make informed decisions about the use of medical devices for wound healing therapy. This paper provides updated evidence and recommendations based on a review of recent publications. The published literature on the use of medical devices for wound healing continues to support the use of hyperbaric oxygen therapy, negative pressure wound therapy, and most recently electrical stimulation. To inform wound healing practitioners of the evidence for or against the use of medical devices for wound healing. This information will aid the practitioner in deciding which technology should be accepted or rejected for clinical use. To produce high quality, randomized controlled trials or acquire outcome-based registry databases to further test and improve the knowledge base as it relates to the use of medical devices in wound care.

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“…As such, makeshift NPWT devices have been contructed in low-resource settings (environment defined by difficulty covering healthcare costs, limited access to supplies, poor infrastructure, or less-trained personnel 27 ). Studies suggest that homemade NPWT devices demonstrate benefits, such as a reduction in reoperation, graft loss, and hospital length of stay, 5,28,29 and reduce costs compared to commercial products ($25.40/day compared to $110.06/ day), 30 but homemade devices lack evidence supporting safety, reliability, and ease of use.…”

mentioning

confidence: 99%

Pilot Study to Assess Safety and Usability of the Kyron NPWT System

Karki

Man

Nakarmi

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background:There is an evident need for Negative Pressure Wound Therapy (NPWT) systems specifically designed for use in resource-constrained settings to aid in the treatment of open wounds.Methods:Prospective single-arm interventional pilot study of 14 patients with complex wounds was conducted at Kirtipur Hospital in Kathmandu, Nepal. A novel NPWT device, the Kyron Suction Unit, was used by 4 plastic surgeons. Primary outcomes were ease of use (10-point Likert scale) and device safety (adverse events recorded). Pain (Visual Analogue Scale score), quality of life (modified EuroQol Derived Single Index scores), and wound dimensions were recorded.Results:User ratings on the 10-point Likert scale indicated high confidence and ease of use: median confidence setting up the device of 1.0 [interquartile range (IQR), 1.0; mean 2.3], median confidence maintaining the device of 1.0 (IQR, 1.0; mean, 1.5), and median ease of disassembly of 1.0 (IQR, 1.0; mean, 1.4). Significant improvement in Visual Analogue Scale scores (P = 0.03), modified EuroQol Derived Single Index scores (P < 0.001), and a reduction in wound volume [median, 47.25–9.75 cm3 (P = 0.01)]. Image analysis of wounds pretreatment and posttreatment demonstrated increase in granulation tissue surface area [median, 7.6–28.7 cm2 (P = 0.003)] and decrease in open wound surface area [median, 48.33–33.6 cm2 (P = 0.01)].Conclusions:The Kyron Suction Unit was safe and easily managed by plastic surgeons. The device design promoted access to NPWT, a therapy proven to reduce healing time and decrease complications for patients with open wounds, in a resource-constrained setting.

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

Cited by 15 publications

References 24 publications

Safeguarding Skin Grafts

Safeguarding Skin Grafts

Wound Healing Devices Brief Vignettes

Pilot Study to Assess Safety and Usability of the Kyron NPWT System

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