Negative pressure wound therapy as an accelerator and stabilizer for incorporation of artificial dermal skin substitutes - A retrospective, non-blinded, and non-randomized comparative study.
Artificial dermal skin substitutes (ADSS)
Negative pressure wound therapy (NPWT)
Split thickness skin graft
Success rate
Vascularization
Journal
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
22
10
2019
revised:
29
05
2020
accepted:
14
08
2020
pubmed:
8
9
2020
medline:
24
2
2021
entrez:
7
9
2020
Statut:
ppublish
Résumé
Artificial dermal skin substitutes (ADSS) in combination with split-thickness skin grafts (STSG) are a valuable option for reconstruction of skin- and soft tissue-defects. However, successful incorporation of ADSS can be limited by various factors. We investigated the anticipated benefits of negative pressure wound therapy (NPWT) as an adjunct to support integration of ADSS, in a retrospective, comparative cohort study. We performed a retrospective, non-blinded, non-randomized comparative study including 86 patients with various soft-tissue defects, managed by application of either ADSS with or without NPWT based on the surgeon's preference. Outcome measurements comprised ADSS and skin graft take rates and analysis of treatment duration and time to wound healing. Additionally, patients were analyzed for the occurrence of hematoma, seroma, wound infection, and lack of substitute or skin graft adhesion. Demographic data and individual risk factors did not differ with statistical significance between both groups. The combination of ADSS with NPWT led to significantly improved rates of ADSS integration (89 vs. 70.1%; p = 0.035) and skin graft take (91 vs. 76%; p = 0.049) compared to standard wound dressings without NPWT. In addition, while differences in the incidence of seroma were neglectable, NPWT application led to significantly reduced rates of infection of ADSS (2.2 vs. 7.3%; p = 0.043). Moreover, STSG could be performed on average 4 days earlier with the application of NPWT (p = 0.031). The addition of NPWT to ADSS is a helpful adjunct that reduces time of incorporation and vascularization and improves clinical success rates.
Sections du résumé
BACKGROUND
Artificial dermal skin substitutes (ADSS) in combination with split-thickness skin grafts (STSG) are a valuable option for reconstruction of skin- and soft tissue-defects. However, successful incorporation of ADSS can be limited by various factors. We investigated the anticipated benefits of negative pressure wound therapy (NPWT) as an adjunct to support integration of ADSS, in a retrospective, comparative cohort study.
PATIENTS AND METHODS
We performed a retrospective, non-blinded, non-randomized comparative study including 86 patients with various soft-tissue defects, managed by application of either ADSS with or without NPWT based on the surgeon's preference. Outcome measurements comprised ADSS and skin graft take rates and analysis of treatment duration and time to wound healing. Additionally, patients were analyzed for the occurrence of hematoma, seroma, wound infection, and lack of substitute or skin graft adhesion.
RESULTS
Demographic data and individual risk factors did not differ with statistical significance between both groups. The combination of ADSS with NPWT led to significantly improved rates of ADSS integration (89 vs. 70.1%; p = 0.035) and skin graft take (91 vs. 76%; p = 0.049) compared to standard wound dressings without NPWT. In addition, while differences in the incidence of seroma were neglectable, NPWT application led to significantly reduced rates of infection of ADSS (2.2 vs. 7.3%; p = 0.043). Moreover, STSG could be performed on average 4 days earlier with the application of NPWT (p = 0.031).
CONCLUSIONS
The addition of NPWT to ADSS is a helpful adjunct that reduces time of incorporation and vascularization and improves clinical success rates.
Identifiants
pubmed: 32893153
pii: S1748-6815(20)30370-3
doi: 10.1016/j.bjps.2020.08.041
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
357-363Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest statement CH has consulted for Integra Lifesciences, Saint Priest, France, and KCI – 3 M, Wiesbaden, Germany. SF and DK received funding from Lohmann & Rauscher GmbH & Co. KG, Neuwied, Germany, for an independent research project. For the remaining authors, none were declared.