Petkar KS, Dhanraj P, Kingsly PM, Sreekar H, Lakshmanarao A, Lamba S, Shetty R, Zachariah JR, et al.
Burns : journal of the International Society for Burn Injuries. Date of publication 2011 Sep 1;volume 37(6):925-9.
1. Burns. 2011 Sep;37(6):925-9. doi: 10.1016/j.burns.2011.05.013. Epub 2011 Jul
1.
A prospective randomized controlled trial comparing negative pressure dressing
and conventional dressing methods on split-thickness skin grafts in burned
patients.
Petkar KS(1), Dhanraj P, Kingsly PM, Sreekar H, Lakshmanarao A, Lamba S, Shetty
R, Zachariah JR.
Author information:
(1)Department of Plastic Surgery, Christian Medical College, Vellore 632 004,
Tamilnadu, India. drkiranpetkar2009@gmail.com
INTRODUCTION: Split-thickness skin grafting (SSG) is a technique used
extensively in the care of burn patients and is fraught with suboptimal graft
take when there is a less-than-ideal graft bed and/or grafting conditions. The
technique of Negative Pressure Dressing (NPD), initially used for better wound
healing has been tried on skin-grafts and has shown to increase the graft take
rates. However, comparative studies between the conventional dressing and vacuum
assisted closure on skin grafts in burn patients are unavailable. The present
study was undertaken to find out if NPD improves graft take as compared to
conventional dressing in burns patients.
MATERIALS AND METHODS: Consecutive burn patients undergoing split-skin grafting
were randomized to receive either a conventional dressing consisting of Vaseline
gauze and cotton pads or to have a NPD of 80 mm Hg for four days over the
freshly laid SSG. The results in terms of amount of graft take, duration of
dressings for the grafted area and the cost of treatment of wound were compared
between the two groups.
RESULTS: A total of 40 split-skin grafts were put on 30 patients. The grafted
wounds included acute and chronic burns wounds and surgically created raw areas
during burn reconstruction. Twenty-one of them received NPD and 19 served as
controls. Patient profiles and average size of the grafts were comparable
between the two groups. The vacuum closure assembly was well tolerated by all
patients. Final graft take at nine days in the study group ranged from 90 to 100
per cent with an average of 96.7 per cent (SD: 3.55). The control group showed a
graft take ranging between 70 and 100 percent with an average graft take of 87.5
percent (SD: 8.73). Mean duration of continued dressings on the grafted area was
8 days in cases (SD: 1.48) and 11 days in controls (SD: 2.2) after surgery. Each
of these differences was found to be statistically significant (p<0.001).
CONCLUSION: Negative pressure dressing improves graft take in burns patients and
can particularly be considered when wound bed and grafting conditions seem
less-than-ideal. The negative pressure can also be effectively assembled using
locally available materials thus significantly reducing the cost of treatment.
Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.
DOI: 10.1016/j.burns.2011.05.013
PMID: 21723044 [Indexed for MEDLINE]
