Mushin Oren P, Bogue Jarrod T, Esquenazi Mica D, Toscano Nicole, Bell Derek E
University of Rochester Medical Center, United States.
University of Rochester Medical Center, United States.
Burns. 2017 May;43(3):490-494. doi: 10.1016/j.burns.2016.08.038. Epub 2017 Feb 28.
The vacuum assisted closure device (VAC) improves wound-healing when utilized as a bolster to secure split thickness skin grafts (STSG). Patients typically remain hospitalized for VAC therapy; however, home VACs (hVAC) are now available. Limited studies examine burns treated with hVAC as a STSG bolster.
A retrospective study of records from an ABA verified regional burn center was conducted over 23 months. Patients included STSGs for burn. Data points included demographics, burn mechanism and location, graft characteristics, hospital length of stay (LOS), and time to heal.
Fifty patients were included, with average age of 39 years (range <1-83years). Average burn TBSA was 1.27±1.42 (range 0.05-8.18). Grafted area average was 102.9±128.1cm. The most commonly treated areas were the leg/foot, thigh, and torso (53%, 16%, and 16%, respectively). Average LOS was 1.1±1.2 days. Mean graft-take was 99.2±2.8% with one patient undergoing repeat STSG. Average post-operative time to heal was 16±6 days. A 5-day inpatient stay with a VAC costs an average of $34,635, compared to $9134 for an hVAC over the same period.
The hVAC is a cost-effective STSG bolster in the burn population for appropriate candidates. Excellent graft-take and low morbidity rates imply that this is an efficacious alternative for STSG bolster.
真空辅助闭合装置（VAC）在用作支撑以固定中厚皮片（STSG）时可改善伤口愈合。患者通常因VAC治疗而住院；然而，现在已有家用VAC（hVAC）。有限的研究探讨了使用hVAC作为STSG支撑物治疗烧伤的情况。
对一家经ABA认证的地区烧伤中心23个月期间的记录进行回顾性研究。患者包括因烧伤接受STSG治疗的患者。数据点包括人口统计学、烧伤机制和部位、移植特征、住院时间（LOS）和愈合时间。
纳入50例患者，平均年龄39岁（范围<1 - 83岁）。平均烧伤总面积为1.27±1.42（范围0.05 - 8.18）。移植面积平均为102.9±128.1平方厘米。最常治疗的部位是腿部/足部、大腿和躯干（分别为53%、16%和16%）。平均住院时间为1.1±1.2天。平均移植成活率为99.2±2.8%，有1例患者接受了再次STSG。术后平均愈合时间为16±6天。使用VAC住院5天的平均费用为34,635美元，而同期使用hVAC的费用为9134美元。
对于合适的烧伤患者，hVAC是一种具有成本效益的STSG支撑物。出色的移植成活率和低发病率表明这是STSG支撑的一种有效替代方法。
