Retrospective evaluation of clinical outcomes in subjects with split-thickness skin graft: comparing V.A.C.® therapy and conventional therapy in foot and ankle reconstructive surgeries

• Published in: International wound journal 2010-12, Vol.7 (6), p.480-487
• Main Authors: Blume, Peter A, Key, Jonathan J, Thakor, Pratapji, Thakor, Sejal, Sumpio, Bauer
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis of Variance; Clinical Nursing Research; Female; Foot Ulcer - etiology; Foot Ulcer - surgery; Graft Survival; Humans; Male; Middle Aged; Negative pressure wound therapy; Negative-Pressure Wound Therapy - methods; Negative-Pressure Wound Therapy - nursing; Original; Postoperative Care - methods; Postoperative Care - nursing; Retrospective Studies; Skin Care - methods; Skin Care - nursing; Skin Transplantation - adverse effects; Skin Transplantation - nursing; Split-thickness skin graft; Surgical Wound Dehiscence - etiology; Surgical Wound Dehiscence - prevention & control; Treatment Outcome; Vacuum-assisted closure; Wound Healing
• ISSN: 1742-4801; 1742-481X
• DOI: 10.1111/j.1742-481X.2010.00728.x

This retrospective study compared the clinical outcomes of negative pressure wound therapy with reticulated open cell foam (NPWT/ROCF) as delivered by Vacuum‐Assisted Therapy® (V.A.C.® Therapy, KCI Licensing Inc., San Antonio, TX) to non‐NPWT/ROCF conventional therapy (CT) in split‐thickness skin graft (STSG) survival in all patients to determine whether NPWT/ROCF affects the outcome of the graft survival, in terms of overall graft take, duration of graft take, repeated grafts and complications. The authors conducted a 10‐year retrospective review of 142 patients admitted to a level I trauma centre and treated with an STSG in foot and ankle reconstructive surgeries. Demographic data, wound etiology, dressing type used, time to graft take, NPWT/ROCF duration, complications and outpatient treatments were analysed. There were significantly fewer repeated STSGs required in the NPWT/ROCF group compared to CT [n = 3 (3·5%) versus n = 9 (16%); P = 0·006]. In assessing safety, there were fewer complications in graft failure (seroma, hematoma and infection) in the NPWT/ROCF group as compared to the CT group at 8·9 months (range: 1–12 months). NPWT/ROCF is an excellent alternative for securing an STSG and is associated with improved graft survival as measured by a reduction in the number of repeated STSGs and graft failure complications.