scholarly journals Negative-pressure dressings in lower limb skin grafts: a randomised control trial of PICO versus standard dressings

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Lisa Ellis ◽  
Patricia Terrill ◽  
Warren Rozen
Keyword(s):  
Negative Pressure ◽  
Lower Limb ◽  
Primary Objective ◽  
Patient Comfort ◽  
Randomised Control Trial ◽  
Split Thickness Skin Graft ◽  
Graft Take ◽  
Thickness Skin ◽  
Significant Difference ◽  
Negative Pressure Dressings

Objective: Negative-pressure wound therapy (NPWT) can reduce the incidence of exudate and haematoma beneath a split-thickness skin graft (SSG) compared with traditional standard dressings. However, NPWT has not been universally adopted for lower limb SSGs despite evidence that its use is linked with improved graft take and a tendency towards early mobilisation. PICO (Smith and Nephew®), an ultra-lightweight NPWT device now available in Australia, can provide a smaller, more manageable NPWT dressing. The primary objective of this study was to compare lower limb graft take rate in PICO versus standard dressing groups, and a secondary objective was comparing quality of life (QOL) in these groups. Method: A prospective, randomised control trial was conducted of 71 lower limb wounds from 59 patients, with 36 wounds randomised to standard dressings and 35 to PICO dressings. Graft take was measured and expressed as a percentage of total wound area. Postoperative mobilisation day, patient comfort, complication frequencies, ease of dressing removal and QOL scores were also recorded. Results: The graft area percentage was not statistically significantly different between the PICO and standard dressing groups (p=0.054). All patients in the PICO group were mobilised by postoperative day one, but 8 per cent in the standard dressing group were still not mobilised by postoperative day five (PICO vs standard, p=0.003). There was no statistically significant difference in patient comfort, patient QOL or complication frequency in the PICO versus standard dressing group at any postoperative visit, but the PICO dressings were statistically significantly easier to remove (p=0.04). Conclusion: PICO dressings are not inferior or superior to standard dressings for lower limb SSGs.

Full-Thickness Skin Grafts: Maximizing Graft Take Using Negative Pressure Dressings to Prepare the Graft Bed

2008 ◽  
Vol 60 (6) ◽  
pp. 661-666 ◽  
Author(s):  
Alex G. Landau ◽  
Don A. Hudson ◽  
Kevin Adams ◽  
Stuart Geldenhuys ◽  
Conrad Pienaar
Keyword(s):  
Negative Pressure ◽  
Skin Grafts ◽  
Full Thickness ◽  
Full Thickness Skin ◽  
Graft Take ◽  
Thickness Skin ◽  
Negative Pressure Dressings

scholarly journals Evaluation of skin graft take following post-burn raw area in normovolaemic anaemia

2009 ◽  
Vol 42 (02) ◽  
pp. 195-198 ◽  
Author(s):  
Pawan Agarwal ◽  
Brijesh Prajapati ◽  
D. Sharma
Keyword(s):  
Wound Healing ◽  
Haemoglobin Level ◽  
Skin Graft ◽  
Control Group ◽  
Split Thickness Skin Graft ◽  
Graft Take ◽  
Thickness Skin ◽  
Significant Difference ◽  
Oxygen Carrying Capacity ◽  
Moderate Anaemia

ABSTRACT Background: Traditional wisdom is that wound healing is directly related to haemoglobin level in the blood; therefore blood transfusion is given in anaemic patients to raise the haemoglobin level for better wound healing. Methods: Evaluation of wound healing in the form of split thickness skin graft take was done in 35 normovolaemic anaemic patients (haemoglobin level of < 10 gm/ dl) and compared with control group (patients with haemoglobin level of 10 or > 10 gm/ dl). Results: There was no statistically significant difference in mean graft take between the two groups. Conclusion: It is not mandatory to keep haemoglobin level at or >10 g/dL or PCV value at or >30% for skin graft take, as mild to moderate anaemia per se does not cause any deleterious effect on wound healing; provided perfusion is maintained by adequate circulatory volume. Prophylactic transfusion to increase the oxygen carrying capacity of the blood for the purpose of wound healing is not indicated in asymptomatic normovolemic anaemic patients (with haemoglobin levels greater than 6g/dL) without significant cardiovascular or pulmonary disease.

A Comparison of Negative-Pressure Dressings Versus Bolster and Splinting of the Radial Forearm Donor Site

2005 ◽  
Vol 133 (3) ◽  
pp. 403-406 ◽  
Author(s):  
D. Macy Vidrine ◽  
Steven Kaler ◽  
Eben L. Rosenthal
Keyword(s):  
Graft Survival ◽  
Skin Graft ◽  
Negative Pressure ◽  
Donor Site ◽  
Graft Loss ◽  
Split Thickness Skin Graft ◽  
Thickness Skin ◽  
Radial Forearm ◽  
Wound Healing Problems ◽  
Negative Pressure Dressings

OBJECTIVE: Negative-pressure dressings (NPDs) have been reported to improve split-thickness skin graft survival in some settings; we assessed whether NPDs could improve skin graft results in radial forearm donor sites. METHODS: Between October 2003 and November 2004, 45 radial forearm donor sites underwent split-thickness skin graft immobilization either with conventional bolster dressing and splint or with an NPD. Split-thickness skin graft take was recorded at 1 and 4 weeks postoperatively. RESULTS: Overall split-thickness skin graft healing was improved in the NPD group (92%) compared with the case of conventional splinting (81%) at 4 weeks ( P =. 10). The rate of major graft loss was less in NPDs (10%) compared with the case of conventional management (28%) after 4 weeks ( P =. 06). CONCLUSIONS: Split-thickness skin graft survival was significantly improved by the use of NPDs. Because the use of NPDs is expensive, we consider their use only in patients with potential wound-healing problems, when there is a need to monitor the hand, or when immediate postoperative hand immobilization might impede the patient's recovery.

scholarly journals Efficacy Of Gauze-based Negative Pressure Wound Therapy After Split-thickness Skin Graft In The Care Of Large Wounds

2018 ◽  
Vol 08 (02) ◽  
pp. 82-86
Author(s):  
Irfan Ilahi ◽  
M. Uzair Ilyas Tahir Kheli ◽  
Ehtesham- ulHaq
Keyword(s):  
Skin Graft ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Cost Effective ◽  
Military Hospital ◽  
Split Thickness Skin Graft ◽  
Wound Therapy ◽  
Thickness Skin ◽  
User Friendly ◽  
Over The Top

Background: Negative-pressure wound therapy (NPWT) or vacuum dressings involve the application of a controlled negative pressure on the wound. Traditionally, STSGs were fixed with bolster technique, where sutures are used to fix pressure dressings over the top of recently placed grafts. Taking it a step further in our study we applied an effective and user friendly filler material (surgical roll gauze) on very large defects. The objective of this study was to assess the clinical efficacy of gauze-based negative pressure wound therapy as an adjunctive therapy to STSG, over complex and very large wounds. Material & Methods: This descriptive study was conducted at Army Burn Center, Combined Military Hospital Kharian and PNS Shifa Hospital Karachi from January 2016 to June 2017. Gauze based VAC system used. Negative pressure was applied at -80 mm Hg. Evaluation was carried out to assess the performance of gauze-based NPWT. Results: Total of 63 patients, 42 males and 21 females, with mean age of 32 years SD+15 were included in the study. The wound size included in the study ranged from 12x10 cm to 88x66 cm. Mean duration of NPWT dressings was 15 days and 313 dressings were employed in total with satisfactory healing achieved in 3 to 4 VAC dressings in most of the cases. Mean duration of hospital stay was 23.92 days at which point graft uptake percentage was in the range of 90% (n=7) to 100% (n=20). Only 3.2% (n=2) cases required partial re-grafting for complete coverage of residual wounds. Conclusion: Gauze-based Negative-pressure wound therapy over split thickness skin graft is a cost-effective addition to the care and management of large and complex wounds

scholarly journals A comparative study of the efficacy of topical negative pressure moist dressings and conventional moist dressings in chronic wounds

2007 ◽  
Vol 40 (02) ◽  
pp. 133-140
Author(s):  
Surajit Bhattacharya ◽  
J Ravikrishnan ◽  
B S Satish Rao ◽  
H. Divakar Shenoy ◽  
S R Shetty ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Surface Area ◽  
Negative Pressure ◽  
Chronic Wounds ◽  
Tissue Formation ◽  
Granulation Tissue Formation ◽  
Topical Negative Pressure ◽  
Graft Take ◽  
The Mean ◽  
Negative Pressure Dressings

ABSTRACT Aim: To assess the efficacy of topical negative pressure moist wound dressing as compared to conventional moist wound dressings in improving the healing process in chronic wounds and to prove that negative pressure dressings can be used as a much better treatment option in the management of chronic wounds. Materials and Methods: This is a prospective comparative study of data from 112 patients with chronic wounds, of which 56 patients underwent topical negative pressure dressings (17 diabetic, 10 pressure sores, nine ischemic, two varicose, 10 post-infective raw areas and eight traumatic - six had bone exposed, two orthopaedic prosthesis exposed). The remaining 56 patients underwent conventional moist dressings (20 diabetic, two ischemic, 15 pressure sores, three varicose, eight post-infective raw areas and eight traumatic - five had bone exposed, three orthopaedic prosthesis exposed). The results were compared after 10 days. The variables compared were, rate of granulation tissue formation as a percentage of ulcer area covered, skin graft take up as the percentage of ulcer surface area and duration of hospital stay. The variables were compared using Unpaired Student′s t test. A " P" value < 0.05 was considered significant. Results: Out of 56 patients who underwent topical negative pressure dressings, six (10.71%) were failures, due to failure in maintaining topical negative pressure due to defective sealing technique; these were included into the study group. After 10 days, the mean rate of granulation tissue formation was 71.43% of ulcer surface area. All these 56 cases underwent split-thickness skin grafting. The mean graft take-up was 79.29%. The mean hospital stay was 32.64 days. In the remaining 56 patients, the mean rate of granulation tissue formation was 52.85% of ulcer surface area. The mean graft take-up was only 60.45% of the total ulcer surface area. The mean hospital stay was 60.45 days. Conclusion: To conclude, topical negative pressure dressings help in faster healing of chronic wounds and better graft take-up and reduce hospital stay of these patients.

scholarly journals Use of negative-pressure wound therapy and split-thickness skin autograft to cover an exposed renal transplant

2019 ◽  
Vol 12 (9) ◽  
pp. e231197
Author(s):  
Victoria Elizabeth McKinnon ◽  
Jouseph Barkho ◽  
Mark H McRae
Keyword(s):  
Case Report ◽  
Renal Transplant ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Rare Event ◽  
Split Thickness Skin Graft ◽  
Flap Surgery ◽  
Wound Therapy ◽  
Thickness Skin ◽  
Reconstructive Option

Exposure of a renal transplant through the abdominal wall is a rare event. A search of the literature reveals only six documented cases which used skin autograft for coverage, with none reported since 1981, and none which used negative-pressure wound therapy (NPWT) to prepare the recipient bed. This case report demonstrates that NPWT followed by split thickness skin graft is a reconstructive option which is feasible in patients who are at high risk for surgical complications in prolonged flap surgery.

Use of Negative-Pressure Dressings and Split-Thickness Skin Grafts Following Penile Shaft Reduction and Reduction Scrotoplasty in the Management of Penoscrotal Elephantiasis

2006 ◽  
Vol 56 (6) ◽  
pp. 649-653 ◽  
Author(s):  
Tracey H. Stokes ◽  
Keith E. Follmar ◽  
Ari D. Silverstein ◽  
Alon Z. Weizer ◽  
Craig F. Donatucci ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Skin Grafts ◽  
Penile Shaft ◽  
Thickness Skin ◽  
Negative Pressure Dressings
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