Early Mobilization of Patients After Split-Thickness Skin Grafting to the Lower Extremities With the Use of Subatmospheric Pressure Wound Therapy

A Feasibility Study

Abstract

Purpose: 

This retrospective study was undertaken to assess whether early mobilization with the use of subatmospheric pressure wound therapy (SAWT) over lower extremity split-thickness skin grafts (STSG) would affect graft adherence.

Methods: 

A retrospective review of the medical records of 154 patients with lower extremity wounds that were closed with STSG, secured by SAWT dressings, and were mobilized the first day after surgery was undertaken. The following variables were analyzed during the record review: patient age, size of skin graft in square centimeters, the number of hours on SAWT after STSG, graft adherence in square centimeters, length of hospital stay after STSG, and discharge destination.

Results: 

All 154 patients were mobilized on postoperative day 1. Skin grafts were adherent without fluid collections in all 154 patients upon removal of the SAWT at 96 hours post-surgery. Of the 154 patients, 128 patients (83.1%) were discharged by postoperative day 5. A total of 138 patients (89.6%) were discharged by postoperative day 6. Before the use of SAWT to secure lower extremity grafts, patients at our institution with STSG to the lower extremity remained hospitalized on bed rest for 7 days.

Conclusions: 

This retrospective study finds that the use of SAWT is an effective method to secure skin grafts, allowing for earlier mobilization of patients with good graft adherence. Earlier mobilization may minimize the negative effects of prolonged bed rest associated with hospitalization and offers a cost-effective treatment method.