科研之友
微信
新浪微博
Facebook
分享链接
摘要
Objective: To evaluate a single centre experience with the use of NPWT for securing split-thickness skin grafts in the management of specifically lower extremity chronic wounds, including revascularised arterial wounds, amputations, diabetic and venous leg ulcers.
Method:A seven-year retrospective review of a prospectively maintained database of all the patients who underwent primary split-thickness skin grafts (STSG) with immediate postoperative NPWT for at least 96 hours was carried out. The percentage graft take after removal of NPWT device and clinical follow-up date were reviewed.
Results: A total of 59 skin grafts procedures had adequate follow up to be reviewed. This included 39% post-debridement/ amputation wounds in patients that presented with diabetic foot infection/ gangrene, 31% venous leg ulcers, and 31% other post-surgical wounds (arterial ulcers that had undergone revascularisation). The mean percentage graft survival after removal of VAC was 94%; 63% of cases had complete graft survival, 25% had 90-99% survival, and 8.5% had 80-89% survival. Outpatient follow up ranged from 2 weeks to 5 years (mean of 10 months). Fifteen per cent of patients were lost to follow up, and of the remaining patients, 76% remained completely healed, 10% remained partially healed, and 14% lost the entire STSG.
Conclusion: Patients with STSG secured with NPWT required fewer repeated grafting procedures, had very high initial graft survival with complete recipient bed coverage, and had good long term wound closure rates compared with historical controls. While retrospective reviews, such as this, support NPWT as a good method of STSG affixation, the paucity of reviews of other methods does not allow for good historic comparison, so a well enrolled prospective trial would be of use.
- 出版日期2011-10
