title: Use of a home vacuum-assisted closure device in the burn population is both cost-effective and efficacious.
abstract: BACKGROUND
  The vacuum assisted closure device (VAC) improves wound-healing when utilized as a bolster to secure split thickness skin grafts (STSG). Patients typically remain hospitalized for VAC therapy; however, home VACs (hVAC) are now available. Limited studies examine burns treated with hVAC as a STSG bolster.
  
  
  METHODS
  A retrospective study of records from an ABA verified regional burn center was conducted over 23 months. Patients included STSGs for burn. Data points included demographics, burn mechanism and location, graft characteristics, hospital length of stay (LOS), and time to heal.
  
  
  CONCLUSIONS
  Fifty patients were included, with average age of 39 years (range <1-83years). Average burn TBSA was 1.27±1.42 (range 0.05-8.18). Grafted area average was 102.9±128.1cm2. The most commonly treated areas were the leg/foot, thigh, and torso (53%, 16%, and 16%, respectively). Average LOS was 1.1±1.2 days. Mean graft-take was 99.2±2.8% with one patient undergoing repeat STSG. Average post-operative time to heal was 16±6 days. A 5-day inpatient stay with a VAC costs an average of $34,635, compared to $9134 for an hVAC over the same period.
  
  
  CONCLUSIONS
  The hVAC is a cost-effective STSG bolster in the burn population for appropriate candidates. Excellent graft-take and low morbidity rates imply that this is an efficacious alternative for STSG bolster.
authors.affiliation: University of Rochester Medical Center, United States.
authors.forename: Oren P
authors.initials: OP
authors.lastname: Mushin
authors.affiliation: University of Rochester Medical Center, United States.
authors.forename: Jarrod T
authors.initials: JT
authors.lastname: Bogue
authors.affiliation: University of Rochester Medical Center, United States.
authors.forename: Mica D
authors.initials: MD
authors.lastname: Esquenazi
authors.affiliation: University of Rochester Medical Center, United States.
authors.forename: Nicole
authors.initials: N
authors.lastname: Toscano
authors.affiliation: University of Rochester Medical Center, United States. Electronic address: Derek_Bell@urmc.rochester.edu.
authors.forename: Derek E
authors.initials: DE
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Home VAC; Negative pressure wound therapy; Skin graft; VAC; Vacuum assisted closure device; hVAC