title: An Alternative Treatment Strategy for Complicated Chronic Wounds: Negative Pressure Therapy over Mesh Skin Graft.
abstract: Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors. Of these, 15 were treated with the application of V.A.C.® Therapy (KCI Medical S.r.l., Milan, Italy), in combination with skin grafts after a prior unsuccessful treatment of 4 weeks with mesh skin grafts and dressings. Another 8 were treated with only mesh skin graft. Pain reduction and wound area reduction were found statistically significant (p< 0.0009,p< 0.0001). Infection was resolved in almost all patients. According to our study, the use of the negative pressure wound therapy over mesh skin grafts is significantly effective especially in wounds resistant to conventional therapies, thereby improving the rate of skin graft take.
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy; Emergency and Organ Transplantation Department, University of Bari "Aldo Moro", Plastic and Reconstructive Surgery and Burns Unit, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Maruccia
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Onesti
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Sorvillo
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Albano
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Luca A
authors.initials: LA
authors.lastname: Dessy
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Carlesimo
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Tarallo
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Marco
authors.identifier: 0000-0003-0540-5982
authors.initials: M
authors.lastname: Marcasciano
authors.affiliation: Emergency and Organ Transplantation Department, University of Bari "Aldo Moro", Plastic and Reconstructive Surgery and Burns Unit, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giudice
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cigna
authors.affiliation: "Valdoni" Surgery Department, Plastic and Reconstructive Surgery Unit, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Roma, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058128:Compression Bandages; D005260:Female; D006097:Granulation Tissue / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D059408:Pain Management; D011312:Pressure; D011446:Prospective Studies; D012867:Skin; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult