Combined Application of Negative Pressure Wound Therapy and Dermal Substitute for Coverage of a Complex Cutaneous Defect: A Case Report

Abstract

Abrasion burns are a type of skin injury commonly associated with friction trauma, such as those caused by automobile accidents. These wounds, although superficial in appearance, can involve large areas of the integument and require surgical treatment to achieve adequate functional and aesthetic healing. We present the case of a female patient who suffered an extensive abrasion burn on her upper limb following a high-energy vehicle accident. The initial approach included surgical cleansing and placement of negative pressure therapy (vacuum-assisted closure system (VAC®)) to prepare the wound bed. This method allowed for exudate control, reduced bacterial load, and stimulated granulation tissue formation, all of which are necessary for subsequent reconstruction. Once the recipient site was optimized, a full-thickness autologous skin graft was placed, which showed adequate integration, without infectious complications or signs of rejection. The postoperative course was favorable, with progressive functional recovery and satisfactory aesthetic results. The patient presented no complications during follow-up. This case highlights the importance of using negative pressure therapy as an effective adjuvant in the management of complex acute wounds, allowing for better preparation of the recipient site and facilitating graft integration. It also emphasizes the need for a comprehensive and timely approach to the treatment of abrasion burns, especially in traumatic settings, where prompt intervention can directly influence clinical outcomes and patient quality of life. Early surgical management, combined with advanced wound care techniques, remains a cornerstone for optimizing recovery, minimizing scarring, and restoring limb function in patients with severe abrasion burns.