Randomized comparative study of negative pressure wound therapy versus compression dressing on split-thickness skin grafts of the lower limbs in an elderly population

ABSTRACT

Introduction

Failure to adequately secure the skin graft to the lower limbs recipient bed can result in loss of the graft. Our objective was to compare the healing of split-thickness skin grafts three weeks postoperatively, using either negative pressure wound therapy (NPWT) or conventional compression bandaging.

Methods

In this multicenter randomized controlled study, patients with tissue loss ranging from 50 cm² to 600 cm² on the lower limbs and treated with split-thickness skin grafts were included in three French hospitals. A digital photographic evaluation was performed at 3 weeks.

Results

During 9 years, 70 patients were included in the study and allocated to a treatment group. The grafted area was similar in both groups. Loss of graft was significantly reduced in the NPWT group with 14.6 cm2 compared to 29 cm2 in the control group (p = 0.0003). The hospital stay was also significantly reduced in the NPWT group, at 4 days versus 6.5 days in the control group (p = 0.0284). In the NPWT group, 60% reported pain compared to 22.9% in the control group (p = 0.0048).

Conclusions

The use of NPWT dressings improves skin graft take by reducing necrosis, improving the graft’s adherence to the recipient site, and reducing hospital length-of-stay.

KEYWORDS:

• Skin graft
• lower limbs
• elderly population
• NPWT therapy
• compression dressing
• graft necrosis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Data access

All data are available upon request from the first author, Dr. Vivien Moris.

Acknowledgments

The authors thank Suzanne Rankin from the Dijon University Hospital for her help with English language editing of the manuscript.

Additional information

Funding

This paper was not funded.