The vacuum assisted closure device: A method of securing skin grafts and improving graft survival

Lynette A. Scherer, Stephen Shiver, Michael Chang, J. Wayne Meredith, John T Owings

Research output: Contribution to journalArticle

234 Scopus citations

Abstract

Hypothesis: Use of the vacuum assisted closure device (VAC) for securing split-thickness skin grafts (STSGs) is associated with improved wound outcomes compared with bolster dressings. Design: Consecutive case series. Patients and Setting: Consecutive patients at a level I trauma center requiring STSG due to traumatic or thermal tissue loss during an 18-month period. Main Outcome Measure: Repeated skin grafting due to failure of the initial graft. Secondary outcome measures included dressing-associated complications, percentage of graft take, and length of hospital stay. Results: Sixty-one patients underwent STSG placement. Indications for STSG were burn injury (n=32), soft tissue loss (n=27), and fasciotomy-site coverage (n=2). Patients were treated with the VAC (n=34) or the bolster dressing (n=27). The VAC group required significantly fewer repeated STSGs (1 [3%] vs 5 [19%]; P=.04). Two additional graft failures occurred in the no-VAC group, but repeated STSGs were refused by these patients. No difference was seen between the groups in age, percentage of graft take, or hospital length of stay. The no-VAC group had significantly larger grafts (mean ± SD, 984 ± 996 vs 386 ± 573 cm 2; P=.006). The patients requiring repeated STSGs (n=6) did not have significantly larger grafts than those not requiring repeated STSGs (mean ± SD, 617 ± 717 vs 658 ± 857 cm 2; P=.62). No dressing-associated complications occurred in the VAC group. Conclusions: The VAC provides a safe and effective method for securing STSGs and is associated with improved graft survival as measured by a reduction in number of repeated STSGs.

Original languageEnglish (US)
Pages (from-to)930-934
Number of pages5
JournalArchives of Surgery
Volume137
Issue number8
StatePublished - 2002

ASJC Scopus subject areas

  • Surgery

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