Vacuum-assisted closure dressing in split-thickness skin grafting

Abstract

Vacuum-assisted closure (VAC) has been applied to a variety of acute and chronic wounds that are difficult to manage, and is associated with improved wound healing outcomes. It involves the application of sub-atmospheric pressure in a controlled way to secure a split-thickness skin graft on the wound that has been sealed with an occlusive dressing.A study was conducted on the patients with a variety of indications for skin grafting, admitted to Azadi Teaching Hospital between March 2010 and August 2017. After the application of split-thickness skin graft, a closed, controlled suction was applied on the wound. The graft was then continuously observed, and the dressing was changed as needed.A total of 39 split-thickness skin grafting procedures were performed on 37 patients (20 male, 17 female), the age of the patients ranging between 7 and 68 years. The average grafted area was 12±70 cm2, and the percent graft take ranged from 90 - 100%.Vacuum-assisted closure opposes the graft firmly on the wound bed, sucks out the seroma and/or hematoma, prevents shearing of the graft and aids in immobilization of the grafted part; thus improving the quantity and quality of the graft take. This study also established that VAC was particularly useful when the wound site is difficult to access, the wound is highly contoured and the conditions are less-than-ideal for complete graft take.