Sweitzer Keith, Tomtschik Julia, Butterfield James, Bell Derek
University of Rochester, Department of Surgery, Division of Plastic Surgery, 601 Elmwood Ave., Rochester, New York 14642, USA.
J Burn Care Res. 2023 Jan 5;44(1):136-139. doi: 10.1093/jbcr/irac122.
Negative-pressure wound therapy (NPWT) over split thickness skin grafts can control exudate, decrease infection rates, and improve revascularization. However, no study specifically addresses differences in outcomes between meshed/perforated and non-meshed autologous skin grafts dressed with NPWT. Through retrospective chart review, patients undergoing autologous split thickness skin grafting with a NPWT dressing for any burn injury over a 10-month period were identified. Data on etiology, graft take, meshed/perforated or non-meshed graft, graft size, and seroma/hematoma incidence were collected. Our study included 123 patients who had STSG with NPWT and consisted of 57% males, 57% Caucasian, and an average age of 41. Burn injury etiologies consisted of scald (55%), chemical (25%), flame (15%), and contact (5%). Average 2nd degree TBSA in our cohort was 2.34%, 3rd degree TBSA 4.50%, and total TBSA 5.35%. 66.7% of patients received non-meshed grafts, and these patients had an average graft area of 76.5 cm2. 33.3% of patients received meshed grafts, with an average graft area of 163.5 cm2. Non-meshed burn grafts were significantly smaller than meshed grafts (P = .04). There was 100% graft take and 0% seroma/hematoma formation in all patients. Data was analyzed using an unpaired student's T test and ANOVA testing. There were no statistically significant differences in patient demographics, or burn etiology. There exist many options for dressings after repair of burn injuries, each with its own unique advantages. There were, however, no differences in graft take or incidence of seroma/hematoma formation using a NPWT dressing over autologous meshed grafts vs non-meshed grafts. Our data shows that NPWT use as a bolster dressing is safe and efficacious overlying meshed skin grafts and non-meshed grafts.
在中厚皮片上应用负压伤口治疗(NPWT)可控制渗出液、降低感染率并改善血管再生。然而,尚无研究专门探讨使用NPWT敷料的网状/穿孔自体皮片与非网状自体皮片在治疗效果上的差异。通过回顾性病历审查,确定了在10个月期间因任何烧伤接受NPWT敷料自体中厚皮片移植的患者。收集了病因、植皮成活情况、网状/穿孔或非网状植皮、植皮面积以及血清肿/血肿发生率等数据。我们的研究纳入了123例接受NPWT治疗的中厚皮片移植患者,其中男性占57%,白种人占57%,平均年龄为41岁。烧伤病因包括烫伤(55%)、化学伤(25%)、火焰伤(15%)和接触伤(5%)。我们队列中的平均二度烧伤总面积为2.34%,三度烧伤总面积为4.50%,总烧伤面积为5.35%。66.7%的患者接受了非网状植皮,这些患者的平均植皮面积为76.5平方厘米。33.3%的患者接受了网状植皮,平均植皮面积为163.5平方厘米。非网状烧伤植皮明显小于网状植皮(P = 0.04)。所有患者的植皮均100%成活,血清肿/血肿形成率为0%。使用不成对学生t检验和方差分析进行数据分析。患者人口统计学特征或烧伤病因无统计学显著差异。烧伤创面修复后有多种敷料选择,每种都有其独特优势。然而,在自体网状植皮与非网状植皮上使用NPWT敷料,在植皮成活或血清肿/血肿形成发生率方面并无差异。我们的数据表明,NPWT作为一种支撑敷料覆盖在网状皮片和非网状皮片上是安全有效的。