(PI-014) Use of Negative Pressure Wound Therapy with an All-in-one Dressing to Manage Split Thickness Skin Grafts in Three Patients with Venous Leg Ulcers

Split-thickness skin grafts (STSGs) are a valuable tool in the management of Venous Leg Ulcers (VLUs). An all-in-one dressing has recently become available for use with negative pressure wound therapy (NPWT). This dressing is designed with an incorporated silicone-acrylic adhesive drape and perforated non-adherent layer to be worn for up to 7 days and facilitates fast and simple dressing application and removal. This study evaluated the use of NPWT with the all-in-one dressing to manage STSGs in three patients with VLUs.

Methods:

Prior to STSG, the wound bed was prepared using surgical debridement and NPWTi-d* with ROCF dressings^†. After STSG, NPWT^‡ and all-in-one dressing^§ were applied to bolster the STSG. A negative pressure of -125 mmHg was utilized with dressing changes every 7 days. Placental allograft was placed over the STSG to optimize healing. STSGs and periwound skin were assessed at each dressing change.

Results: Three female patients between the ages of 63-86 years with a history of venous insufficiency (n=3), hypertension (n=3), lupus (n=2), diabetes mellitus (n=1), cirrhosis (n=1), and breast cancer (n=1) presented for care. STSGs were managed with NPWT and all-in-one dressing, treatment duration ranged from 1 to 5 weeks. Two patients had 100% graft take and one patient had 75%-80% graft take due to non-compliance.

Discussion: Wound bed preparation and use off the all-in-one dressing with NPWT over the STSG was well tolerated by all patients. Application of the all-in-one dressing with NPWT over the STSGs resulted in granulation tissue formation and improved graft take in these patients. The dressing application was simple and fewer dressing changes were required.