Comparative effectiveness study between negative pressure wound therapy and conventional wound dressing on perforator flap at the Chinese tertiary referral teaching hospital

J Tissue Viability. 2017 Nov;26(4):282-288. doi: 10.1016/j.jtv.2017.07.002. Epub 2017 Jul 12.

Abstract

Background: Perforator flap techniques with conventional wound dressing have being extensively used in the management of soft-tissue defects. However; the flap's survival rate is not always guaranteed and the wound healing time always long. The aim of this study was to investigate the clinical effectiveness use of a freshly transplanted perforator flap in conjunction with Vacuum-assisted closure (VAC) for better clinical outcomes.

Methods: A prospective, randomized, effectiveness study comparing the clinical outcomes of VAC versus traditional wrap and bandages for the treatment of open wounds that required hospital admission and operative debridement using perforator flaps, was carried out from March 1, 2014 to March 31, 2016 at Wuhan University Zhongnan Hospital. Fifty-one eligible patients were randomized into two groups; study group (perforator flaps covered by VAC) and control group (perforator flaps covered by traditional wrap and bandages). The measured clinical endpoints included the time of the first post-operative dressing change, pain visual analogical scale, perforator flap infection rate, 95% perforator flap healing time and percentage of survived perforator flap.

Results: There was no statistically significant difference in the demographic profiles in the two cohorts. There were statistically significant differences in the clinical endpoints in the two groups (p < 0.001; p < 0.05, Table 2).

Conclusions: In summary, VAC combining with perforator flap technique, can diminish accumulated exudation of the transferring flap, protect against postoperative infection, prolong the interval between perforator flap relocation and first postoperative dressing change, decrease pain during removal of dressing, increase perforator flap survival rate, and shorten wound healing time, with a good aesthetic outcome, a good mobility and a satisfactory therapeutic result.

Keywords: Conventional wound dressing care; Negative pressure wound therapy; Perforator flap; Traumatic wounds reconstructive closure; Vacuum assisted closure therapy.

MeSH terms

  • Adult
  • Bandages / standards*
  • China
  • Cohort Studies
  • Female
  • Hospitals, Teaching / organization & administration
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy / standards*
  • Perforator Flap / surgery*
  • Prospective Studies
  • Tertiary Care Centers / organization & administration
  • Treatment Outcome*
  • Wound Healing*