A comparison of negative-pressure dressings versus Bolster and splinting of the radial forearm donor site.
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.
Vidrine
D Macy
DM
Department of Surgery, Division of Otolaryngology at the University of Alabama at Birmingham, 35294, USA.
Kaler
Steven
S
Rosenthal
Eben L
EL
D004322:Drainage; D005260:Female; D005542:Forearm / Q000601:surgery*; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007103:Immobilization; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D011182:Postoperative Care; D011312:Pressure; D011446:Prospective Studies; D016038:Skin Transplantation; D013165:Splints