Vaccum-Assisted Closure Therapy in Split-Thickness Skin Graft on the Wound on the Contours of the Body

Abstract

Introduction: For successful skin grafting, contact between the graft and the wound bed is important. To promote close contact between the graft and the wound, a splint or bolster dressing was applied to the graft site. However, the splint could not be fit into wound on the contours of the body. Patients complained about the use of splint due to their inconvenience. Therefore, we present the method of a vacuum-assisted closure (VAC) therapy, a replacement for the use of a splint on the graft site, that can improve graft survival rate on wounds on the contours of the body. Methods: Through a chart review, we studied medical records from January 2014 to July 2017. Wounds on the contours of the body of 106 patients were healed with VAC therapy following skin graft. The data was collected for characteristics such as age, sex, size of wounds, and underlying disease, complications. Results: Among 106 patients, there was 1 patient for face, 2 for neck, 6 for anterior chest, 1 for shoulder, 2 for axilla, 1 for back, 8 for arm, 3 for hand, 1 for sacrum, 3 for buttock, 2 for trochanter, 9 for thigh, 27 for lower leg, 43 for foot. There were 4 patients for active bleeding, 5 for minor hematoma, 2 for partial graft loss. Conclusions: VAC therapy reduced graft loss and improved graft success rate due its close contact ability. The patient was satisfied with the ease of dressing and handiness. In addition, patients and medical staff have satisfactory results due to increased mobility during hospitalization. Applicability of Research to Practice: This research attempted to report the utility of performing negative pressure wound therapy in parallel with skin grafting on the wounds on the contours of the body, which are difficult to care for by applying a splint and the existing dressing treatment. (Figure Presented) .