Evaluation of the Use of Negative Pressure Wound Therapy for Securing Split-Thickness Skin Grafts for Coverage of Chronic Wounds

Abstract

Abstract Background Split-thickness skin grafting (STSG) is a versatile reconstructive option that has passed the test of time. However, many factors can cause poor graft take. Negative pressure wound therapy (NPWT) has transformed the management of complicated wounds and has been used as a means for securing split-thickness skin grafts (STSG). The role of NPWT in the fixation of grafts was compared to conventional Tie over bolster dressing. Aim of the Work To assess whether NPWT would result in a better graft take especially in wounds with large surface area. Patients and Methods This is a parallel group randomized control study. conducted from November 2021 to June 2022 in the Plastic, burns, and maxillofacial Surgery Department, Ain Shams University Hospitals. Block randomization of 52 patients into one of the two groups (NPWT vs. non-NPWT; 26 patients each) was done. Graft take/loss and length of hospital stay post-grafting were assessed. Results Mean graft take in the NPWT group was quantitatively and qualitatively better than that in the non-NPWT group. None of the patients in the NPWT group required a second coverage procedure. No major complication was encountered with the use of NPWT. Conclusion Compared with conventional tie over bolster dressing, NPWT is a simple, yet powerful and effective alternative in the integration of STSG. It significantly increases the rate of graft take especially in large wounds, while reducing rates of complications and hence re-operation.