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Comparative Study
. 2015 Jul;29(7):301-6.
doi: 10.1097/BOT.0000000000000259.

Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

Laurence B Kempton  1 , Timothy B Larson, Harvey E Montijo, Rachel B Seymour, Stanely B Getz, Michael J Bosse
Affiliations
Comparative Study

Increased Cost of Negative Pressure Dressings Is Not Justified for Split-Thickness Skin Grafting of Low-Risk Wounds

Laurence B Kempton et al. J Orthop Trauma. 2015 Jul.

Abstract

Objectives: (1) To determine whether negative pressure dressings (NPDs) are superior to conventional compressive dressings (CDs) for split-thickness skin grafts (STSGs) placed on healthy, low-risk wounds, (2) To determine the cost difference of NPDs versus that of CDs.

Design: Retrospective.

Setting: Level I Trauma Center.

Patients/participants: One hundred ninety-five traumatic wounds treated with STSG.

Main outcome measurements: Patients were assigned outcomes based on postoperative documentation: completely healed, incompletely healed (small areas of graft necrosis), failed, or lost to follow-up. The costs associated with each dressing type were documented.

Results: Thirty five of 195 STSGs were lost to follow-up, leaving n = 120 STSG-NPD, n = 40 STSG-CD. Of the remaining 120 STSGs treated with NPD, 91 completely healed, 23 incompletely healed, and 6 failed. Of the 40 STSGs treated with a CD, 37 completely healed, 1 incompletely healed, and 2 failed. Patients treated with CDs had a higher likelihood of healing relative to those treated with the NPD (P = 0.018). Analyzing the outcomes as failed versus "not failed" revealed no significant difference between the groups (P = 1.00). There were more smokers in the CD group (P = 0.022). In this series, the mean cost associated with NPD compared with that of CD was $2370 more per patient.

Conclusions: There is a high rate of successful healing of STSGs for traumatic extremity wounds regardless of the dressing used. The increased cost of NPDs is not justified in wounds that are at a low risk of developing STSG failure.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Comment in

  • Invited Commentary.
    Sanders R, Sagi HC. Sanders R, et al. J Orthop Trauma. 2015 Jul;29(7):306. doi: 10.1097/BOT.0000000000000260. J Orthop Trauma. 2015. PMID: 26091528 No abstract available.
  • In Response.
    Kempton LB, Larson TB, Montijo HE, Seymour RB, Getz SB, Bosse MJ. Kempton LB, et al. J Orthop Trauma. 2015 Jul;29(7):306-7. doi: 10.1097/01.bot.0000467183.34037.8c. J Orthop Trauma. 2015. PMID: 26091529 No abstract available.

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