A Pilot Study to Compare the Efficacy of Negative Pressure Wound Therapy over Split-Thickness Skin Graft and the Conventional Method of Fixation of Grafts on Wound Healing

Objectives: The standard method of resurfacing wounds that fail to heal secondarily is skin grafting. Prerequisites for successful graft take are a healthy wound bed and adequate adherence. In multiple previous studies, none of the several split-thickness skin graft (STSG) fixation methods were proven to be superior to conventional fixation. In our study, we compare the outcomes of STSG using negative pressure wound therapy (NPWT) fixation vs. conventional fixation concerning the percentage of graft taken, soakage and number of dressings during the first two weeks, time of healing, complications, length of hospital stay and aesthetic results. Material and Methods: A randomized controlled pilot study was conducted at a tertiary care hospital on patients requiring STSG cover from 2019-21. A total of 60 patients were randomly allocated to two groups. After STSG, one group received NPWT dressings and the other conventional dressings. Post-procedure wound inspections were carried out, and outcome characteristics were noted. Special emphasis was paid to the number of dressing changes required in the conventional group and the aesthetic outcomes were compared using hypertrophy and pigmentation. The data was analyzed using Statistical Package for Social Sciences (SPSS) Software version 27.0 Results: Soakage of the first dressing was observed in 11 cases (40.74%) in the STSG group (Group S) compared to 4 cases (12.12%) in the STSG + NPWT group (Group N). The Group S participants required a total of 80 dressings (68.96%) in the first two weeks compared to 36 dressings in Group N (31.03%). Graft take in Group N was 96.96% compared to 80.76% in Group S. Good aesthetic results were seen in 24 patients (77.41%) in Group N compared to 13 participants of Group S (61.90%) Conclusion: Compared to Group S, the STSG + NPWT group (Group N) showed increased take of the graft, fewer number of dressings and lesser graft loss. All these factors also significantly decreased the average length of the hospital stay and need for repeat surgery.