title: Skin graft secured by VAC (vacuum-assisted closure) therapy in chronic leg ulcers: A controlled randomized study.
abstract: BACKGROUND
  Leg ulcers are a common condition. There have been very few studies of combined therapy involving VAC (vacuum-assisted closure) and skin graft.
  
  
  METHODS
  We performed a randomized controlled trial of VAC therapy vs. hydrocolloid dressings over 5 days following autologous grafting on chronic leg ulcers. The primary objective was to assess the difference in success (defined as a reduction in wound area of at least 50% at 1 month) between the two dressing methods. Forty-six patients with ulcers present for over one month were included. Following a 7-day hospitalization period, follow-up was performed for 3 months on an outpatient basis.
  
  
  RESULTS
  Our study does not demonstrate a statistically significant difference, with a 45.8% success rate in the VAC group vs. 40.9% in the conventional dressing group (P=0.73). In the venous ulcer group, the success rate was 57.9% for VAC vs. 40% for conventional dressings (P=0.3). The difference in favor of VAC in this group was not statistically significant, most likely due to an insufficient number of patients studied.
  
  
  CONCLUSIONS
  Our study does not demonstrate superiority of VAC associated with skin graft over conventional dressings. We observed more complications with VAC (40%) than with conventional dressings (23%) (P=0.06).
authors.affiliation: Dermatology Department, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: A
authors.initials: A
authors.lastname: Leclercq
authors.affiliation: Dermatology Department, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. Electronic address: bruno.labeille@chu-st-etienne.fr.
authors.forename: B
authors.initials: B
authors.lastname: Labeille
authors.affiliation: Dermatology Department, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Perrot
authors.affiliation: Department of Public Health and Medical Information, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: P
authors.initials: P
authors.lastname: Vercherin
authors.affiliation: Dermatology Department, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: F
authors.initials: F
authors.lastname: Cambazard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D047070:Bandages, Hydrocolloid; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D011446:Prospective Studies; D011788:Quality of Life; D016038:Skin Transplantation; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000601:surgery
keywords: Chronic leg ulcer; Greffe cutanée; Pression négative; Skin graft; Ulcère chronique de jambe; VAC therapy; VAC-thérapie; Vacuum-associated closure