We read with great interest the Viewpoint article entitled Simplified Negative-Pressure Wound Therapy System for Skin Graft Wounds.1 The authors describe an easy and simple method of using a negative-pressure system on skin grafts. The method, though simple in concept, has a few flaws.
We tried similar therapy and found that the system does not sustain negative pressure for more than 1 hour and needs regular recharging. This repeated manipulation is not only cumbersome but has a high chance of graft shear. This fluctuation in pressure is against the standard protocols used when negative-pressure therapy is applied following skin grafting.2,3 Negative-pressure therapy after skin grafting is generally maintained until the fourth postoperative day. This is intended to provide splintage of the graft like a tie-over dressing and thus avoid any shearing of the graft from the wound bed until the graft takes. Generally, negative-pressure dressings following skin grafting have minimal drainage from the wound site, especially from wounds as small as 5 × 5 cm. In the study, the need for 6-hourly evacuation of fluid from the syringe is surprising.
New innovations in negative-pressure therapy aim at a cost-effective method. This endeavor should not be at the cost of continuous reliable therapy.
The authors have no financial interest to declare in relation to the content of this communication.
Harinatha Sreekar, M.B.B.S., M.S., M.Ch.
Shashank Lambda, M.B.B.S., M.S., M.Ch.
Ashish K. Gupta, M.B.B.S., M.S., M.Ch.
Christian Medical College
Vellore, Tamilnadu, India
1. Li TS, Choong MY, Wu HF, Chung KC. Simplified negative-pressure wound therapy system for skin graft wounds. Plast Reconstr Surg.. 2012;129:399e–401e.
2. Scherer LA, Shiver S, Chang M, Meredith JW, Owings JT. The vacuum assisted closure device: A method of securing skin grafts and improving graft survival. Arch Surg.. 2002;137:930–933 discussion 933–934
3. Llanos S, Danilla S, Barraza C. Effectiveness of negative pressure closure in the integration of split thickness skin grafts: A randomized, double-masked, controlled trial. Ann Surg.. 2006;244:700–705