Securing split-thickness skin grafts using negative-pressure wound therapy without suture fixation

2019 ◽  
Vol 28 (Sup8) ◽  
pp. S16-S21
Author(s):  
Yusuke Inatomi ◽  
Hideki Kadota ◽  
Kenichi Kamizono ◽  
Masuo Hanada ◽  
Sei Yoshida
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Statistical Significance ◽  
Operation Time ◽  
Control Group ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Significant Difference ◽  
Suture Group

Objective: Negative-pressure wound therapy (NPWT) is generally applied as a bolster for split-thickness skin grafts (STSG) after the graft has been secured with sutures or skin staples. In this study, NPWT was applied to secure STSGs without any sutures or staples. Surgical outcomes of using NPWT without sutures was compared with a control group. Methods: Patients with STSGs were divided into two groups: a ‘no suture’ group using only NPWT, and a control group using conventional fixings. In the no suture group, the grafts were covered with meshed wound dressing and ointment. The NPWT foam was placed over the STSG and negative pressure applied. In the control group, grafts were fixed in place using tie-over bolster, securing with fibrin glue, or NPWT after sutures. Results: A total of 30 patients with 35 graft sites participated in the study. The mean rate of graft take in the no suture group was 95.1%, compared with 93.3% in the control group, with no significant difference between them. No graft shearing occurred in the no suture group. Although the difference did not reach statistical significance, mean surgical time in the no suture group (31.5 minutes) tended to be shorter than that in the control group (55.7 minutes). Conclusion: By eliminating sutures, the operation time tended to be shorter, suturing was avoided and suture removal was not required meaning that patients could avoid the pain associated with this procedure. Furthermore, the potential for staple retention and its associated complications was avoided, making this method potentially beneficial for both medical staff and patients.

A retrospective analysis of securing autologous split-thickness skin grafts with negative pressure wound therapy in paediatric burn patients

Burns ◽  
2014 ◽  
Vol 40 (6) ◽  
pp. 1116-1120 ◽  
Author(s):  
Michael Hoeller ◽  
Michael Valentin Schintler ◽  
Klaus Pfurtscheller ◽  
Lars-Peter Kamolz ◽  
Norbert Tripolt ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Burn Patients ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Thickness Skin

scholarly journals Effects of Negative Pressure Wound Therapy on Healing of Free Full-Thickness Skin Grafts in Dogs

2013 ◽  
Vol 42 (5) ◽  
pp. 511-522 ◽  
Author(s):  
Bryden J. Stanley ◽  
Kathryn A. Pitt ◽  
Christian D. Weder ◽  
Michele C. Fritz ◽  
Joe G. Hauptman ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafts ◽  
Full Thickness ◽  
Wound Therapy ◽  
Full Thickness Skin ◽  
Thickness Skin

scholarly journals Negative Pressure Wound Therapy versus Gauze Dressings in Managing Open Fracture Wound of Lower Limbs: An Update Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Hu Qian ◽  
Ting Lei ◽  
Yihe Hu
Keyword(s):  
Infection Rate ◽  
Negative Pressure ◽  
Open Fracture ◽  
Negative Pressure Wound Therapy ◽  
Meta Analysis ◽  
Lower Limbs ◽  
Cochrane Library ◽  
Control Group ◽  
Wound Therapy ◽  
Significant Difference

Abstract IntroductionWhether the negative pressure wound therapy (NPWT) is superior to standard gauze dressings in managing open fracture wounds of lower limbs still remains a controversy. Herein, we updated a meta-analysis only including RCTs to comprehensively compare the clinical efficacy of the two dressings.Materials and methodsWe searched various databases including PubMed, Web of Science, Medline, Clinicaltrial.gov and Cochrane Library to screen eligible RCTs. Data extraction was performed by two reviewers independently. The data analysis was carried out using the Review Manager 5.3 software.ResultsThere were 10 RCTs, along with 2780 patients, eligible for meta-analysis. We found patients in the NPWT group showed lower overall infection rate (MD = 0.70, 95% CI: 0.54 − 0.90, P = 0.005), acute wound infection rate (MD = 0.35, 95% CI: 0.16 − 0.77, P = 0.009) and shorter hospital stay (MD = 24.00, 95% CI: 6.82–84.46, P < 0.00001) as compared with the control group. And the NPWT group showed higher proportion of patients with wound coverage than the control group. While no significant difference was found between the two groups in terms of function score and other complications including deep infection rate, amputation and bone nonunion.ConclusionBased on the pooled results, we suggested that NPWT could be an alternative choice over traditional gauze dressings in managing the wound of open fracture of lower limbs.

scholarly journals Successful surgical closure of infected abdominal wounds following preconditioning with negative pressure wound therapy

2021 ◽  
Author(s):  
Johanna C. Wagner ◽  
Anja Wetz ◽  
Armin Wiegering ◽  
Johan F. Lock ◽  
Stefan Löb ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Wound Closure ◽  
Negative Pressure Wound Therapy ◽  
Wound Complications ◽  
Skin Closure ◽  
Wound Treatment ◽  
Open Wound ◽  
Wound Therapy ◽  
Significant Difference ◽  
Open Wound Treatment

Abstract Purpose Traditionally, previous wound infection was considered a contraindication to secondary skin closure; however, several case reports describe successful secondary wound closure of wounds “preconditioned” with negative pressure wound therapy (NPWT). Although this has been increasingly applied in daily practice, a systematic analysis of its feasibility has not been published thus far. The aim of this study was to evaluate secondary skin closure in previously infected abdominal wounds following treatment with NPWT. Methods Single-center retrospective analysis of patients with infected abdominal wounds treated with NPWT followed by either secondary skin closure referenced to a group receiving open wound therapy. Endpoints were wound closure rate, wound complications (such as recurrent infection or hernia), and perioperative data (such as duration of NPWT or hospitalization parameters). Results One hundred ninety-eight patients during 2013–2016 received a secondary skin closure after NPWT and were analyzed and referenced to 67 patients in the same period with open wound treatment after NPWT. No significant difference in BMI, chronic immunosuppressive medication, or tobacco use was found between both groups. The mean duration of hospital stay was 30 days with a comparable duration in both patient groups (29 versus 33 days, p = 0.35). Interestingly, only 7.7% of patients after secondary skin closure developed recurrent surgical site infection and in over 80% of patients were discharged with closed wounds requiring only minimal outpatient wound care. Conclusion Surgical skin closure following NPWT of infected abdominal wounds is a good and safe alternative to open wound treatment. It prevents lengthy outpatient wound therapy and is expected to result in a higher quality of life for patients and reduce health care costs.

scholarly journals Full circumference lower extremity degloving injury treated with hydrosurgical debridement and negative-pressure wound therapy with gauze wound filler for fixation of avulsed flap skin grafts

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Tae Nagama ◽  
Natsuko Kakudo ◽  
Atsuyuki Kuro ◽  
Yujiro Ozaki ◽  
Yasuko Shirasawa ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Traumatic Injury ◽  
Skin Grafts ◽  
Wound Therapy ◽  
Left Lower Extremity ◽  
Degloving Injury ◽  
Severe Traumatic Injury ◽  
Degloving Injuries

Abstract Degloving, a skin and subcutis avulsion, is a severe traumatic injury sometimes caused by rolling wheels or machines. Although avulsed flaps are often readapted to its original site, most of these tissues become necrotic. Due to the extensive skin and soft tissue deficiency caused by necrosis, treatment becomes difficult. Skin grafts harvested from avulsed flaps may be used to treat degloving injuries, while negative pressure wound therapy (NPWT) is used to secure the grafts. Commonly used porous polyurethane foam wound fillers are difficult to set in circumferential extremity degloving injuries; gauze-based wound fillers are easier to use and cause less pain during dressing changes. We present a case of an extensive, full-circumference left lower-extremity degloving injury, treated using NPWT with gauze-based wound fillers for fixation of skin grafts harvested from avulsed flaps after hydrosurgical debridement. For complex wound geometries, gauze-based wound fillers can be easily applied for skin graft immobilization.

Negative pressure wound therapy using polyvinyl alcohol foam to bolster full-thickness mesh skin grafts in dogs

2017 ◽  
Vol 46 (3) ◽  
pp. 389-395 ◽  
Author(s):  
Matan Or ◽  
Bart Van Goethem ◽  
Adriaan Kitshoff ◽  
Annika Koenraadt ◽  
Ilona Schwarzkopf ◽  
...  
Keyword(s):  
Polyvinyl Alcohol ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Skin Grafts ◽  
Full Thickness ◽  
Wound Therapy
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