The Use of Negative Pressure Wound Therapy in Patients with Skin Grafts and Flaps

Acute and Chronic wound management represents a considerable burden on health services and requires considerable manpower, frequent consultations and adjunct therapies. Chronic wounds affect patient’s ability to function in their environment causing financial social and psychological consequences as well as affecting their quality of life. Regardless of etiology, wounds are difficult to treat if coexisting factors (e.g., infection or diabetes mellitus) prevent regular wound healing. Wounds represent a significant risk factor for hospitalization, amputation, sepsis, and even death, and from the patient’s perspective, wound therapy is often uncomfortable or painful. Topical Negative pressure devices are believed to hasten the take of graft, removing wound exudates, increasing local blood flow, provide immobilization of graft, applying mechanical pressure to promote wound closure and reducing bacterial load in the wound. In addition to providing an optimal wound bed environment, topical negative pressure has been shown to increase local blood flow to the wound site in initial animal studies. Adequate perfusion is essential to proper take of the graft in order to provide nutrients and to remove inflammatory mediators to the wound and to remove local edema.