title: 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.
abstract: 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.
authors.affiliation: Anesthesia and Orthopedics and Rehabilitation, Yale School of Medicine, 333 Cedar Street, TMP 3, PO Box 208051, New Haven, CT 06520-8051, USA. peter.b@snet.net
authors.forename: Peter A
authors.initials: PA
authors.lastname: Blume
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Key
authors.forename: Pratapji
authors.initials: P
authors.lastname: Thakor
authors.forename: Sejal
authors.initials: S
authors.lastname: Thakor
authors.forename: Bauer
authors.initials: B
authors.lastname: Sumpio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015400:Clinical Nursing Research; D005260:Female; D016523:Foot Ulcer / Q000209:etiology / Q000601:surgery*; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods* / Q000451:nursing; D011182:Postoperative Care / Q000379:methods* / Q000451:nursing; D012189:Retrospective Studies; D017592:Skin Care / Q000379:methods* / Q000451:nursing; D016038:Skin Transplantation / Q000009:adverse effects / Q000451:nursing; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014945:Wound Healing
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