Management of radial forearm donor sites following free flap reconstruction of head and neck tumor defects typically requires split-thickness skin grafting. Tendon exposure and delayed healing are occasional problems associated with skin grafting over the distal forearm musculature. Others have reported the use of negative pressure wound therapy (NPWT) devices to bolster split-thickness grafts and improve graft take. Although this approach works well, these devices are not always approved by third-party payers for outpatient use, requiring patients to remain in the hospital or have these devices removed before discharge. The authors report outcomes using a miniaturized NPWT device to bolster the skin graft on radial forearm free flap donor sites in 10 consecutive patients compared with 10 consecutive control patients managed with traditional bolster dressings. The 2 groups of patients were similar in terms of demographics, indication for reconstruction, and size of donor site. There was less skin graft loss and a lower rate of tendon exposure and infection in the miniaturized NPWT device group, though these results did not reach statistical significance. Recently developed miniaturized, single-use NPWT devices can be reliably used as bolsters for skin grafts with some notable advantages over reusable NPWT devices.
From the Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, N.Y.
Published online 15 June 2018.
Received for publication June 22, 2017; accepted April 20, 2018.
* Drs. Ray and Mitchell contributed equally to this work.
The products used include PICO Single Use NPWT System (Smith & Nephew, Hull, United Kingdom), Adaptic® (Acelity, San Antonio, TX), and Xeroform® (DeRoyal Industries, Inc., Powell, Tenn.).
Disclosure: The authors have no financial interest to declare in relation to the content of this article. This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748. The Article Processing Charge was paid for by the authors.
Peter G. Cordeiro, MD, Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, E-mail: firstname.lastname@example.org
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