Integra (Integra Lifesciences Corporation, Plainsboro, NJ) has been used in a variety of reconstructive surgical procedures. The application of Integra using subatmospheric pressure (V.A.C., Kinetic Concepts, Inc, San Antonio, TX) has been suggested to be easier, faster, and more consistent than previous dressings, allowing grafting as soon as 1 week after Integra placement. Ten patients were chosen for outpatient reconstructive surgery with Integra and subatmospheric pressure with skin grafting 7-10 days (mean = 8 days) post-Integra. Skin graft take was 75% to 100% (mean = 91.5%). No patients required additional grafting or reconstruction. Integra may be successfully used for reconstruction of difficult areas as an outpatient in combination with subatmospheric pressure (V.A.C.). This allows for expedited treatment, decreased morbidity, and lower cost versus standard Integra application.