Securing skin grafts to microvascular free flaps using the vacuum-assisted closure (VAC) device.
We performed microvascular free muscle flaps on 5 patients using the vacuum-assisted closure (VAC) device (KCI, San Antonio, TX) to secure a split-thickness skin graft to the external surface of the flap in each case. This method of skin-graft fixation was selected in each case because of the complex 3-dimensional shape of the flap or because of concerns of inadequate fixation provided by conventional tie-over bolster techniques in regions that experience a significant amount of shear stress. All 5 flaps remained viable throughout the treatment course and all 5 patients experienced excellent skin-graft take. Also, decreased edema was noted in all 5 flaps. We conclude that the VAC device is a useful tool in the fixation of skin grafts to microvascular free flaps and that its use does not compromise free-flap viability.
Hanasono
Matthew M
MM
Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. mhanasono@mdanderson.org
Skoracki
Roman J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D016038:Skin Transplantation; D013524:Surgical Flaps; D014618:Vacuum; D014945:Wound Healing