Seif, O., Abdel Rahman, E., El Kaffas, E., Shoulah, A., Emara, N., Elgendy, E., Abdelhalim, M. (2024). Conventional Bolster Dressing Versus Vacuum-Assisted Closure Device for Securing Split-Thickness Skin Graft in Contoured Wide Raw Area Reconstruction: A Randomized Clinical Trial. The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), 229-235. doi: 10.21608/ejprs.2024.365347
Ola Seif; Emad Abdel Rahman; Emad El Kaffas; Ahmed A Shoulah; Nashwa Mohamed Emara; Eman Ibrahim Elgendy; Mohamed H Abdelhalim. "Conventional Bolster Dressing Versus Vacuum-Assisted Closure Device for Securing Split-Thickness Skin Graft in Contoured Wide Raw Area Reconstruction: A Randomized Clinical Trial". The Egyptian Journal of Plastic and Reconstructive Surgery, 48, 3, 2024, 229-235. doi: 10.21608/ejprs.2024.365347
Seif, O., Abdel Rahman, E., El Kaffas, E., Shoulah, A., Emara, N., Elgendy, E., Abdelhalim, M. (2024). 'Conventional Bolster Dressing Versus Vacuum-Assisted Closure Device for Securing Split-Thickness Skin Graft in Contoured Wide Raw Area Reconstruction: A Randomized Clinical Trial', The Egyptian Journal of Plastic and Reconstructive Surgery, 48(3), pp. 229-235. doi: 10.21608/ejprs.2024.365347
Seif, O., Abdel Rahman, E., El Kaffas, E., Shoulah, A., Emara, N., Elgendy, E., Abdelhalim, M. Conventional Bolster Dressing Versus Vacuum-Assisted Closure Device for Securing Split-Thickness Skin Graft in Contoured Wide Raw Area Reconstruction: A Randomized Clinical Trial. The Egyptian Journal of Plastic and Reconstructive Surgery, 2024; 48(3): 229-235. doi: 10.21608/ejprs.2024.365347
Conventional Bolster Dressing Versus Vacuum-Assisted Closure Device for Securing Split-Thickness Skin Graft in Contoured Wide Raw Area Reconstruction: A Randomized Clinical Trial
1The Departments of Plastic Surgery, Faculty of Medicine, Benha University
2The Departments of General Surgery, Faculty of Medicine, Benha University
3The Departments of General Surgery, Faculty of Medicine, Benha University
4The Departments of Pathology, Faculty of Medicine, Benha University
5The Departments of Pathology, Faculty of Medicine, Benha University
Abstract
Background: Contour wounds that require skin graft closure are frequently situated in unique or complicated anatomical areas, making it difficult and inefficient to stabilize them using traditional bolsters. Objective: The aim of this work is to compare vacuumassisted closure (VAC) with Conventional bolster dressing in terms of graft take, histology of wound healing, hospitalization duration, and expenses. Patients and Methods: In the current study 62 patients were reconstructed using a split thickness skin graft and supported by a VAC (Group A n=31) or a traditional bolster dressing (Group < br />B n=31). The following characteristics were assessed in both groups; operative time, hospital stay. Complications, graft take as well as histological assessment of the skin. Results: The mean age of the included patients in the current study was 42.3±9.34 and 41.1±8.92 in group A and B respectively. Post-operative complications showed statistically significant seroma and hematoma in patients who received conventional bolsters. The histopathological assessment showed that the Hyperkeratosis, pigmentation, neovascularization, collagen deposition and fibroblastic activity were more evident in patients who used VAC (p < 0.001*). Conclusion: VAC device is an effective methos for securing split-thickness skin grafts in contoured wide raw area reconstruction with minimal postoperative complications, better healing and favorable aesthetic outcome.
Sheridan R.: Closure of the excised burn wound: autografts, semipermanent skin substitutes, and permanent skin substitutes. Clin. Plast. Surg., 36: 643-51, 2009. 2- Hazani R., Whitney R. and Wilhelmi B.J.: Optimizing aesthetic results in skin grafting. Am. Surg., 78: 151-4, 2012. 3- Wolf Y., Kalish E., Badani E., Friedman N. and Hauben D.J.: Rubber foam and staples: do they secure skin grafts? A model analysis and proposal of pressure enhancement techniques. Ann. Plast. Surg., 40: 149-55, 1998. 4- Hansbrough W., Doré C. and Hansbrough J.F.: Management of skin-grafted burn wounds with Xeroform and layers of dry coarse-mesh gauze dressing results in excellent graft take and minimal nursing time. J. Burn Care Rehabil, 16: 531-4, 1995. 5- Blackburn II J.H., Boemi L,. Hall W.W., Jeffords K., Hauck R.M., Banducci D.R. and Graham III W.P.: Negative- pressure dressings as a bolster for skin grafts. Ann. Plast. Surg., 40: 453-457, 1998. 6- Moisidis E., Heath T., Boorer C., Ho K. and Deva A.K.: A prospective, blinded, randomized, controlled clinical trial of topical negative pressure use in skin grafting. Plast. Reconstr. Surg., 114: 917-22, 2004. 7- Draaijers L.J., Tempelman F.R., Botman Y.A., Tuinebreijer W.E., Middelkoop E., Kreis R.W. and Van Zuijlen P.P.: The patient and observer scar assessment scale: A reliable and feasible tool for scar evaluation. Plastic and Reconstructive Surgery, Jun. 1, 113 (7): 1960-5, 2004. 8- Sabry M., El-Sherif A., Amr A., Tawfik H., Darwish A. and Ahmed El-Shahat A.: Evaluation of the Healing of Meshed Skin Auto Grafts of 1:3 Meshing Size Covered by Fresh Amniotic Membrane Dressings: A Prospective Multicenter Study. Egypt, J. Plast. Reconstr. Surg., 43 (2): 267-274, 2019. Egypt, J. Plast. Reconstr. Surg., July 2024 235 9- Langtry J.A., Kirkham P., Martin I.C. and Fordyce A.: Tie-over bolster dressings may not be necessary to secure small full thickness skin grafts. Dermatol. Surg., 24: 1350- 1353, 1998. 10- Kromka W., Cameron M. and Fathi R.: Tie-Over Bolster Dressings vs Basting Sutures for the Closure of Full- Thickness Skin Grafts: A Review of the Literature. J. Cutan. Med. Surg., 22: 602-606, 2018. [CrossRef] [Pub- Med]. 11- Waltzman J.T. and Bell D.E.: Vacuum-assisted closure device as a split-thickness skin graft bolster in the burn population. J. Burn Care Res., 35, e338-e342, 2014. [Cross- Ref]. 12- Körber A., Franckson T., Grabbe S. and Dissemond J.: Vacuum assisted closure device improves the take of mesh grafts in chronic leg ulcer patients. Dermatology, 216: 250-256, 2008. [CrossRef]. 13- Scherer L.A., Shiver S., Chang M., Meredith J.W. and Owings J.T.: The vacuum assisted closure device: A method of securing skin grafts and improving graft survival. Arch. Surg., 137: 930-933, 2002. [CrossRef]. 14- Nakamura Y.; Fujisawa Y.; Ishitsuka Y., Tanaka R., Maruyama H., Okiyama N., Watanabe R. and Fujimoto M.: Negative-pressure closure was superior to tie-over technique for stabilization of split-thickness skin graft in large or muscle-exposing defects: A retrospective study. J. Dermatol., 45: 1207-1210, 2018. [CrossRef]. 15- Kantak N.A., Mistry R. and Halvorson E.G.: A review of negative-pressure wound therapy in the management of burn wounds. Burns, 42: 1623-1633, 2016. [CrossRef]. 16- Shin S.H., Kim C., Lee Y.S., Kang J.W. and Chung Y.G.: Feasibility and Advantages of Full Thickness Skin Graft from the Anterolateral Thigh. J. Hand Surg. (Asian Pac. Vol.), 22: 497-502, 2017. [CrossRef]. 17- White R. and Morris C.: Mepitel: A non-adherent wound dressing with Safetac technology. Br. J. Nurs., 18: 58-64, 2009. [CrossRef]. 18- Chou P.R., Wu S.H., Hsieh M.C. and Huang S.H.: Retrospective Study on the Clinical Superiority of the Vacuum- Assisted Closure System with a Silicon-Based Dressing over the Conventional Tie-over Bolster Technique in Skin Graft Fixation. Medicina, 55: 781, 2019. doi:10.3390/medicina55120781 19- Gonzalez A.C., Costa T.F., Andrade Z.D. and Medrado A.R.: Wound healing-A literature review. Anais brasileiros de dermatologia, Oct., 91 (5): 614-20, 2016. 20- Van De Kar A.L., Corion L.U., Smeulders M.J., Draaijers L.J., Van Der Horst C.M. and Van Zuijlen P.P.: Reliable and feasible evaluation of linear scars by the Patient and Observer Scar Assessment Scale. Plastic and Reconstructive Surgery, Aug. 1, 116 (2): 514-22, 20
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