title: A review of negative-pressure wound therapy in the management of burn wounds.
abstract: OBJECTIVE
  Negative pressure has been employed in various aspects of burn care and the aim of this study was to evaluate the evidence for each of those uses.
  
  
  METHODS
  The PubMed and Cochrane CENTRAL databases were queried for articles in the following areas: negative pressure as a dressing for acute burns, intermediate treatment prior to skin grafting, bolster for skin autografts, dressing for integration of dermal substitutes, dressing for skin graft donor sites, and integrated dressing in large burns.
  
  
  RESULTS
  Fifteen studies met our inclusion criteria. One study showed negative pressure wound therapy improved perfusion in acute partial-thickness burns, 8 out of 9 studies showed benefits when used as a skin graft bolster dressing, 1 out of 2 studies showed improved rate of revascularization when used over dermal substitutes, and 1 study showed increased rate of re-epithelialization when used over skin graft donor sites.
  
  
  CONCLUSIONS
  Negative pressure can improve autograft take when used as a bolster dressing. There is limited data to suggest that it may also improve the rate of revascularization of dermal substitutes and promote re-epithelialization of skin graft donor sites. Other uses suggested by studies that did not meet our inclusion criteria include improving vascularity in acute partial-thickness burns and as an integrated dressing for the management of large burns. Further studies are warranted for most clinical applications to establish negative pressure as an effective adjunct in burn wound care.
authors.affiliation: Harvard Combined Residency in Plastic Surgery, 75 Francis Street, Boston, MA 02115, United States.
authors.forename: Neelesh A
authors.initials: NA
authors.lastname: Kantak
authors.affiliation: University of Bristol Medical School, Senate House, Tyndall Avenue, Bristol, UK.
authors.forename: Riyam
authors.initials: R
authors.lastname: Mistry
authors.affiliation: Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Boston, MA 02115, United States. Electronic address: ehalvorson@partners.org.
authors.forename: Eric G
authors.initials: EG
authors.lastname: Halvorson
mesh_terms: D002056:Burns / Q000628:therapy*; D006801:Humans; D054843:Negative-Pressure Wound Therapy; D062326:Re-Epithelialization; D016038:Skin Transplantation / Q000379:methods; D017768:Skin, Artificial; D060053:Transplant Donor Site; D014182:Transplantation, Autologous / Q000379:methods; D014945:Wound Healing
keywords: Burns; Dermal substitutes; Negative pressure wound therapy; Skin grafts; VAC