Conventional Bolster Dressing Versus Vacuum-Assisted Closure Device for Securing Split-Thickness Skin Graft in Contoured Wide Raw Area Reconstruction: A Randomized Clinical Trial

Abstract

Background: Contour wounds that require skin graft closureare frequently situated in unique or complicated anatomicalareas, making it difficult and inefficient to stabilize themusing traditional bolsters.Objective: The aim of this work is to compare vacuumassistedclosure (VAC) with Conventional bolster dressing interms of graft take, histology of wound healing, hospitalizationduration, and expenses.Patients and Methods: In the current study 62 patients werereconstructed using a split thickness skin graft and supported bya VAC (Group A n=31) or a traditional bolster dressing (Group < br />B n=31). The following characteristics were assessed in bothgroups; operative time, hospital stay. Complications, graft takeas well as histological assessment of the skin.Results: The mean age of the included patients in the currentstudy was 42.3±9.34 and 41.1±8.92 in group A and B respectively.Post-operative complications showed statisticallysignificant seroma and hematoma in patients who receivedconventional bolsters. The histopathological assessmentshowed that the Hyperkeratosis, pigmentation, neovascularization,collagen deposition and fibroblastic activity were moreevident in patients who used VAC (p < 0.001*).Conclusion: VAC device is an effective methos for securingsplit-thickness skin grafts in contoured wide raw area reconstructionwith minimal postoperative complications, betterhealing and favorable aesthetic outcome.