Efficacy of negative pressure therapy to enhance take of 1-stage allodermis and a split-thickness graft

Abstract

Negative pressure therapy has been used in various conditions to promote wound healing. It has also been used to secure a skin graft by improving microcirculation and providing tight adhesion between the graft and the recipient bed. The authors coupled the idea of negative pressure therapy for 1-stage allodermis and a split-thickness skin graft. This prospective study presents 47 cases of skin defects treated by 1-stage allodermis and a split-thickness skin graft. The patients were divided into 2 groups either treated with simultaneous aid of negative pressure therapy for 5 days (group 1, n = 37) or a classic tieover dressing (group 2, n = 10). In group 1, 97.8% graft take was noted at day 5 and the mean time until complete healing was 5.8 days. In group 2, 84% graft take was noted at day 5 and mean time until complete healing was 8.9 days with an average number of 3.2 dressings. Statistically significant graft take (day 5) and time until complete healing was noted (P < 0.05). Good aesthetic and functional result mimicking a full-thickness skin graft was achieved in both groups. However, frequent dressings, longer time to heal, and more restriction to the graft site were needed for group 2. Split-thickness skin added to allodermis provided a sufficient amount of dermis to prevent contracture, and the negative pressure therapy ensured fast and complete take of the 2-layered composite graft. This option can be used to achieve healing mimicking a full-thickness skin graft without requiring large full-thickness donor sites.