Körber A, Franckson T, Grabbe S, Dissemond J
Department of Dermatology, Essen University School of Medicine, Essen, Germany.
Dermatology. 2008;216(3):250-6. doi: 10.1159/000112937. Epub 2008 Jan 17.
Vacuum assisted closure (VAC) is established in the management of acute and chronic wounds. In recent years, few data have been published concerning VAC therapy after skin graft transplantation.
The aim of this study was to determine whether postoperative VAC helps assist closure of mesh grafts in chronic leg ulcer patients.
PATIENTS/METHODS: We report a consecutive case series of 54 patients with chronic leg ulcers who received a total of 74 mesh grafts. A postoperative VAC therapy was performed in 28 mesh grafts, and 46 mesh grafts were treated with standard gauze therapy.
In the VAC group, 92.9% of grafts showed complete healing, compared to 67.4% in the control group without postoperative VAC therapy. Differential analysis revealed a negative correlation of the take rate in patients over 70 years of age or in patients suffering from diabetes mellitus or dermatoliposclerosis. Particularly patients with diabetes mellitus and of greater age exhibited improved take rates, both 100%, in the VAC group compared to 50 and 62%, respectively.
The results of our retrospective study demonstrate for the first time the significant benefit of VAC therapy after skin grafting in chronic leg ulcer patients as evaluated in a clinical trial.
负压封闭引流（VAC）已被应用于急慢性伤口的处理。近年来，关于皮肤移植术后VAC治疗的相关数据报道较少。
本研究旨在确定术后VAC是否有助于慢性腿部溃疡患者网状植皮的闭合。
患者/方法：我们报告了一个连续的病例系列，共54例慢性腿部溃疡患者接受了74次网状植皮。28次网状植皮术后采用VAC治疗，46次网状植皮采用标准纱布治疗。
VAC组中，92.9%的植皮完全愈合，而未进行术后VAC治疗的对照组为67.4%。差异分析显示，70岁以上患者、糖尿病患者或皮肤脂肪硬化症患者的植皮成活率呈负相关。特别是糖尿病患者和老年患者，VAC组的植皮成活率分别提高到100%，而对照组分别为50%和62%。
我们的回顾性研究结果首次证明，在一项临床试验评估中，VAC治疗对慢性腿部溃疡患者皮肤移植术后具有显著益处。
