Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2006 Nov;244(5):700-5.
doi: 10.1097/01.sla.0000217745.56657.e5.

Effectiveness of negative pressure closure in the integration of split thickness skin grafts: a randomized, double-masked, controlled trial

Sergio Llanos  1 , Stefan Danilla, Cristina Barraza, Eugenia Armijo, Jose L Piñeros, Maria Quintas, Susana Searle, Wilfredo Calderon
Affiliations
Randomized Controlled Trial

Effectiveness of negative pressure closure in the integration of split thickness skin grafts: a randomized, double-masked, controlled trial

Sergio Llanos et al. Ann Surg. 2006 Nov.

Abstract

Objectives: To determine the effectiveness of the negative pressure closure (NPC) technique in the integration of split-thickness skin grafts (STSG) to the recipient site.

Methods: Randomized, double-masked, controlled trial.

Setting: A tertiary burn unit.

Patient characteristics: Between May 2003 and October 2004, 60 patients having wounds with skin loss which hindered primary closure, were incorporated to this study. We excluded patients with > or =20% of total body surface burns, polytraumatized, surgical contraindications, those who were enlisted in other clinical trials, and those who rejected the informed consent.

Interventions: In all the patients, surgical cleaning of the recipient site and STSG were performed after which they were randomly assigned between 2 groups: a group that received a NPC dressing and were connected to the central aspiration system at -80 mm Hg versus a control group with similar dressing but without connection to negative pressure. Loss of STSG area at the fourth postoperative day, days of hospital stay.

Results: Sixty patients were included. The median loss of the STSG in the NPC group was 0.0 cm versus 4.5 cm in the control group (P = 0.001). The median hospital stay was of 13.5 days in the NPC group versus 17 days in the control group (P < 0.001).

Conclusions: The use of NPC significantly diminishes the loss of STSG area, as well as shortens the days of hospital stay. Therefore, it should be routinely used for these kinds of procedures.

PubMed Disclaimer

Figures

None
FIGURE 1. Design of the trial.
None
FIGURE 2. A, Schematic drawing of the NPC dressing. B–F, The procedure sequence.
None
FIGURE 3. For the measurement of area loss, first the total area (left panel) is marked and then the area loss (right panel) is delimitated.
None
FIGURE 4. Box-plot explanation: upper horizontal line of box, 75th centile; lower horizontal line, 25th centile; horizontal bar within box, median; upper horizontal bar outside box, 90th centile; lower bar outside box, 10th centile, extreme values as dots. Note that all the stadigraphs are smaller (lesser) in the NPC group.
None
FIGURE 5. In the left scatter plot, the correlation between graft size and graft loss in the control group is shown. Note that this correlation is truncated with the use of NPC dressing (right scatter plot).
See this image and copyright information in PMC

References

    1. Grabb WC, Smith JW. Plastic Surgery, 5th ed. New York: Lippincott-Raven, 1997:27–35.
    1. Morykwas MJ, Argenta LC, Shelton-Brown EI, et al. Vacuum-assisted closure. A new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg. 1997;38:553–562. - PubMed
    1. Medina A, Vallejo F, Roa R, Uso de sistema aspiración tracción (SAT) en cobertura cutánea compleja. Cuadernos Chilenos de Cirugía. 1997;41:163–167.
    1. Blackburn JH, Boemi L, Hall WW. Negative pressure dressings as a bolster for skin grafts. Ann Plast Surg. 1998;40:453–457. - PubMed
    1. Weed T, Ratliff C, Brake D. Quantifying bacterial bioburden during negative pressure wound therapy. Ann Plast Surg. 2004;52:276–280. - PubMed

Publication types