Document Detail


An improved alternative to vacuum-assisted closure (VAC) as a negative pressure dressing in lower limb split skin grafting: a clinical trial.
MedLine Citation:
PMID:  18267313     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of negative pressure in the dressing of split skin grafts has been shown to promote healing by a variety of mechanisms, including a decrease in interstitial oedema, an increase in perfusion and a decrease in bacterial colonisation. Vacuum-assisted closure (VAC) dressings have, until now, been used as the archetype for negative pressure dressings and have been reflected as such in the literature. However, patient mobility and cost are still an issue with these dressings, and alternatives have been keenly sought. We describe an alternative method of negative pressure dressing, which we have found to be a safe and successful alternative in the setting of lower limb split skin grafts. MATERIALS AND METHODS: A prospective cohort investigation was performed on nine consecutive patients at Monash Medical Centre undergoing split-skin grafting for a lower limb soft tissue defect. The dressing comprised a single cut foam sheet, a conventional disposable closed-system suction drain and an adhesive dressing. RESULTS: In all nine patients, there was a 100% take of the graft, with no partial or complete loss. There were no complications encountered. Cost analysis demonstrated a minimum treatment cost of $577 over 5 days compared to $3180 for commercial VAC dressed wounds: a net saving of $2603 per patient. CONCLUSIONS: The use of a simple suction drain is a cheap and safe alternative to commercial VAC dressings for the treatment of lower limb split skin grafts. Length of hospital stay and cost are superior to VAC, with no diminished clinical outcome.
Authors:
Warren Matthew Rozen; Shekhib Shahbaz; Adel Morsi
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2007-03-09
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  61     ISSN:  1748-6815     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-12     Completed Date:  2008-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  334-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia. warrenrozen@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Disposable Equipment / economics
Female
Health Care Costs / statistics & numerical data
Humans
Length of Stay
Lower Extremity / surgery*
Middle Aged
Negative-Pressure Wound Therapy / economics,  instrumentation*,  methods
Postoperative Care / economics,  instrumentation,  methods
Prospective Studies
Skin Transplantation / methods*
Suction / instrumentation,  methods
Treatment Outcome
Victoria
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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