Abstract:
Background: Negative-pressure wound therapy (NPWT) or vacuum dressings involve the application of a controlled
negative pressure on the wound. Traditionally, STSGs were fixed with bolster technique, where sutures are used to fix
pressure dressings over the top of recently placed grafts. Taking it a step further in our study we applied an effective and
user friendly filler material (surgical roll gauze) on very large defects. The objective of this study was to assess the clinical
efficacy of gauze-based negative pressure wound therapy as an adjunctive therapy to STSG, over complex and very large
wounds.
Material & Methods: This descriptive study was conducted at Army Burn Center, Combined Military Hospital Kharian
and PNS Shifa Hospital Karachi from January 2016 to June 2017. Gauze based VAC system used. Negative pressure was
applied at -80 mm Hg. Evaluation was carried out to assess the performance of gauze-based NPWT.
Results: Total of 63 patients, 42 males and 21 females, with mean age of 32 years SD+15 were included in the study. The
wound size included in the study ranged from 12x10 cm to 88x66 cm. Mean duration of NPWT dressings was 15 days
and 313 dressings were employed in total with satisfactory healing achieved in 3 to 4 VAC dressings in most of the cases.
Mean duration of hospital stay was 23.92 days at which point graft uptake percentage was in the range of 90% (n=7) to
100% (n=20). Only 3.2% (n=2) cases required partial re-grafting for complete coverage of residual wounds.
Conclusion: Gauze-based Negative-pressure wound therapy over split thickness skin graft is a cost-effective addition to
the care and management of large and complex wounds
