Experience with the use of negative pressure bolster dressing for stabilization of skin grafts

Abstract

Background: The ability to apply a skin graft snugly to the bed, and limit shearing forces, goes a long way in determining outcome. It is often a challenge achieving this over highly contoured wounds and wounds located on highly mobile regions of the body, where the use of external splints pose some difficulty.

Objective: To assess the outcome of negative pressure wound dressing as an alternative means of skin graft stabilization over contoured wounds and wounds located in complex anatomic regions of the body.

Methodology: This was a prospective study of consecutive patients from January 2009 to December 2010, with wounds over uneven and highly mobile anatomic regions that had their skin grafts stabilized using negative pressure wound dressing. Data on patients’ age, sex, region of the body that was skin grafted, size of skin graft and graft-take were analysed using descriptive statistics.

Results: There were 12 patients with 15 wounds. Regions of the body involved were the dorsum of the hand(6), the anterior chest wall (3), the anterior neck region(1), the axilla(2), the elbow region(1), the dorsum of the foot(1) and a below knee amputation stump(1). Wound sizes ranged from 80cm² to 192cm². Nine wounds were covered with partial thickness skin grafts, while 6 had full thickness skin grafts. Graft survival was 98 to 100% in all wounds with no case of graft infection.

Conclusion: Negative pressure dressing is an effective means of graft stabilization over anatomically complex wounds.

Keywords: Anatomic region, Complex, Outcome, Wounds