Customize your JAMA Network experience by selecting one or more topics from the list below.
Scherer LA, Shiver S, Chang M, Meredith JW, Owings JT. The Vacuum Assisted Closure Device: A Method of Securing Skin Grafts and Improving Graft Survival. Arch Surg. 2002;137(8):930–934. doi:https://doi.org/10.1001/archsurg.137.8.930
Use of the vacuum assisted closure device (VAC) for securing split-thickness skin grafts (STSGs) is associated with improved wound outcomes compared with bolster dressings.
Consecutive case series.
Patients and Setting
Consecutive patients at a level I trauma center requiring STSG due to traumatic or thermal tissue loss during an 18-month period.
Main Outcome Measure
Repeated skin grafting due to failure of the initial graft. Secondary outcome measures included dressing-associated complications, percentage of graft take, and length of hospital stay.
Sixty-one patients underwent STSG placement. Indications for STSG were burn injury (n = 32), soft tissue loss (n = 27), and fasciotomy-site coverage (n = 2). Patients were treated with the VAC (n = 34) or the bolster dressing (n = 27). The VAC group required significantly fewer repeated STSGs (1 [3%] vs 5 [19%]; P = .04). Two additional graft failures occurred in the no-VAC group, but repeated STSGs were refused by these patients. No difference was seen between the groups in age, percentage of graft take, or hospital length of stay. The no-VAC group had significantly larger grafts (mean ± SD, 984 ± 996 vs 386 ± 573 cm2; P = .006). The patients requiring repeated STSGs (n = 6)did not have significantly larger grafts than those not requiring repeated STSGs (mean ± SD, 617 ± 717 vs 658 ± 857 cm2; P = .62). No dressing-associated complications occurred in the VAC group.
The VAC provides a safe and effective method for securing STSGs and is associated with improved graft survival as measured by a reduction in number of repeated STSGs.
Create a personal account or sign in to: