title: Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds.
abstract: OBJECTIVE
  (1) To determine whether negative pressure dressings (NPDs) are superior to conventional compressive dressings (CDs) for split-thickness skin grafts (STSGs) placed on healthy, low-risk wounds, (2) To determine the cost difference of NPDs versus that of CDs.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Level I Trauma Center.
  
  
  METHODS
  One hundred ninety-five traumatic wounds treated with STSG.
  
  
  METHODS
  Patients were assigned outcomes based on postoperative documentation: completely healed, incompletely healed (small areas of graft necrosis), failed, or lost to follow-up. The costs associated with each dressing type were documented.
  
  
  RESULTS
  Thirty five of 195 STSGs were lost to follow-up, leaving n = 120 STSG-NPD, n = 40 STSG-CD. Of the remaining 120 STSGs treated with NPD, 91 completely healed, 23 incompletely healed, and 6 failed. Of the 40 STSGs treated with a CD, 37 completely healed, 1 incompletely healed, and 2 failed. Patients treated with CDs had a higher likelihood of healing relative to those treated with the NPD (P = 0.018). Analyzing the outcomes as failed versus "not failed" revealed no significant difference between the groups (P = 1.00). There were more smokers in the CD group (P = 0.022). In this series, the mean cost associated with NPD compared with that of CD was $2370 more per patient.
  
  
  CONCLUSIONS
  There is a high rate of successful healing of STSGs for traumatic extremity wounds regardless of the dressing used. The increased cost of NPDs is not justified in wounds that are at a low risk of developing STSG failure.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Departments of *Orthopaedic Surgery, and †General Surgery, Carolinas Medical Center, Charlotte, NC.
authors.forename: Laurence B
authors.initials: LB
authors.lastname: Kempton
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Larson
authors.forename: Harvey E
authors.initials: HE
authors.lastname: Montijo
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Seymour
authors.forename: Stanely B
authors.initials: SB
authors.lastname: Getz
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bosse
mesh_terms: D000328:Adult; D001458:Bandages / Q000191:economics; D003362:Cost-Benefit Analysis; D062109:Dermatologic Surgical Procedures; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000191:economics*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*