Effectiveness of negative pressure closure in the integration of split thickness skin grafts: a randomized, double-masked, controlled trial.

OBJECTIVES: To determine the effectiveness of the negative pressure closure (NPC) technique in the integration of split-thickness skin grafts (STSG) to the recipient site.

METHODS: Randomized, double-masked, controlled trial.

SETTING: A tertiary burn unit.

PATIENT CHARACTERISTICS: Between May 2003 and October 2004, 60 patients having wounds with skin loss which hindered primary closure, were incorporated to this study. We excluded patients with > or =20% of total body surface burns, polytraumatized, surgical contraindications, those who were enlisted in other clinical trials, and those who rejected the informed consent.

INTERVENTIONS: In all the patients, surgical cleaning of the recipient site and STSG were performed after which they were randomly assigned between 2 groups: a group that received a NPC dressing and were connected to the central aspiration system at -80 mm Hg versus a control group with similar dressing but without connection to negative pressure. Loss of STSG area at the fourth postoperative day, days of hospital stay.

RESULTS: Sixty patients were included. The median loss of the STSG in the NPC group was 0.0 cm versus 4.5 cm in the control group (P = 0.001). The median hospital stay was of 13.5 days in the NPC group versus 17 days in the control group (P < 0.001).

CONCLUSIONS: The use of NPC significantly diminishes the loss of STSG area, as well as shortens the days of hospital stay. Therefore, it should be routinely used for these kinds of procedures.