Interrupting Negative-pressure Wound Therapy with Dakin's Solution Is Associated with Increased Skin Graft Survival.

Abstract

We performed a controlled retrospective case series on three groups of STSG patients treated between January 2014 and December 2020: bolster dressings, continuous NPWT (C-NPWT), and Dakin's NPWT (D-NPWT). Patients with documented measurements of STSG survival were included. The primary outcome was the percentage of STSG take calculated by survival area using surgical tape measures 2 weeks after surgery. Fifty-nine patients were followed up for greater than or equal to 3 months. Average wound size for bolsters was smaller than that for D-NPWT (83 cm2 versus 204 cm2; P < 0.05). Average treatment time was 6.4 ± 2.4 days (bolsters), 6.5 ± 0.9 days (C-NPWT), and 2.8 ± 0.9 days (D-NPWT; P < 0.01). Average percentage of STSG take was 92% ± 0% (bolsters), 82% ± 0% (C-NPWT), and 99% ± 0% (D-NPWT; P < 0.01); there were significant differences between bolsters versus C-NPWT (P < 0.05) and C-NPWT versus D-NPWT (P < 0.05), but not between bolsters and D-NPWT. Interrupting NPWT with 0.125% Dakin's solution cleansing is associated with increased STSG survival compared with standard NPWT protocols, but not bolster dressings. These findings warrant further investigation due to limitations of this retrospective case series.