ABSTRACT
Background: Split-thickness skin grafting (STSG) is a time-tested technique in wound cover, but
many factors lead to suboptimal graft take. Role of custom-made negative-pressure
wound therapy (NPWT) is compared with conventional dress in the integration of STSG
and its cost is compared with widely used commercially available NPWT. Materials and Methods: This is a parallel group randomised control study. Block randomisation of 100 patients
into one of the two groups (NPWT vs. non-NPWT; 50 patients each) was done. Graft take/loss,
length of hospital stay post-grafting, need for regrafting and cost of custom-made
negative pressure wound therapy (NPWT) dressings as compared to widely used commercially
available NPWT were assessed. Results: Mean graft take in the NPWT group was 99.74% ± 0.73% compared to 88.52% ± 9.47% in
the non-NPWT group (P = 0.004). None of the patients in the NPWT group required second coverage procedure
as opposed to six cases in the non-NPWT group (P = 0.035). All the patients in the NPWT group were discharged within 4–9 days from
the day of grafting. No major complication was encountered with the use of custom-made
NPWT. Custom-made NPWT dressings were found to be 22 times cheaper than the widely
used commercially available NPWT. Conclusions: Custom-made NPWT is a safe, simple and effective technique in the integration of
STSG as compared to the conventional dressings. We have been able to reduce the financial
burden on the patients as well as the hospital significantly while achieving results
at par with other studies which have used commercially available NPWT.
KEY WORDS
Negative-pressure wound therapy - skin transplantation - wounds and injuries