A Retrospective Review Evaluating the Novel Application of a Mechanically-Powered, Disposable Negative Pressure Wound Therapy System to Bolster Skin Grafts

Background: Traditionally, the recipient site dressing after skin grafting involves a tie-over bolster or the application of a conventional negative pressure wound therapy device (NPWT).

Purpose: The purpose of this study was to evaluate recipient site outcomes following the application of a mechanically-powered, disposable negative pressure wound therapy device (dNPWT) to bolster skin grafts.

Methods: A retrospective single institution review was conducted during a three-month period. Three patients with four wounds (n= 4) received tissue grafting and dNPWT bolster dressing. A non-adherent dressing was placed over the graft to protect it. Each dNPWT dressing was removed 5-7 days postoperatively. Each graft was assessed at 1, 4, and 12 weeks post-operatively. Two grafts were composite in nature, one was full thickness and one was a split thickness skin graft (STSG). The first patient underwent bilateral reduction mammoplasty with nipple-areolar complex (NAC) grafting. The second patient underwent wide local excision of a malignant lesion from the dorsal forearm with a full thickness skin graft. The third patient underwent STSG to the right dorsal foot for closure of a diabetic foot wound. In this case, the recipient site was prepared with conventional NPWT. Within the operating room, all four grafts were bolstered with dNPWT applied at a subatmospheric pressure of -125 mmHg.

Results: All four grafts were 100% viable and intact during follow-up at 1, 4 and 12 weeks.  Notably, no patients returned to the operating room for revision of the grafting procedure. We describe positive recipient site outcomes in a small retrospective review of 4 grafts bolstered with dNPWT.

Conclusions: The device is easily deployed and is a practical alternative to conventional NPWT in the bolstering of grafts.