Yin Y, Zhang R, Li S, Guo J, Hou Z, Zhang Y, et al.
International journal of surgery (London, England). Date of publication 2018 Feb 1;volume 50():43-48.
1. Int J Surg. 2018 Feb;50:43-48. doi: 10.1016/j.ijsu.2017.12.020. Epub 2017 Dec 29.
Negative-pressure therapy versus conventional therapy on split-thickness skin
graft: A systematic review and meta-analysis.
Yin Y(1), Zhang R(2), Li S(3), Guo J(4), Hou Z(5), Zhang Y(6).
Author information:
(1)Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical
University, Key Laboratory of Biomechanics of Hebei Province, No. 139 Ziqiang
Road, Qiaoxi District, Shijiazhuang, 050051, Hebei Province, China. Electronic
address: dryingchao@gmail.com.
(2)Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical
University, Key Laboratory of Biomechanics of Hebei Province, No. 139 Ziqiang
Road, Qiaoxi District, Shijiazhuang, 050051, Hebei Province, China. Electronic
address: zhangruipengdoctor@126.com.
(3)Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical
University, Key Laboratory of Biomechanics of Hebei Province, No. 139 Ziqiang
Road, Qiaoxi District, Shijiazhuang, 050051, Hebei Province, China. Electronic
address: lshilun@163.com.
(4)Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical
University, Key Laboratory of Biomechanics of Hebei Province, No. 139 Ziqiang
Road, Qiaoxi District, Shijiazhuang, 050051, Hebei Province, China. Electronic
address: guojialiang11123@163.com.
(5)Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical
University, Key Laboratory of Biomechanics of Hebei Province, No. 139 Ziqiang
Road, Qiaoxi District, Shijiazhuang, 050051, Hebei Province, China. Electronic
address: drzyhou@gmail.com.
(6)Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical
University, Key Laboratory of Biomechanics of Hebei Province, No. 139 Ziqiang
Road, Qiaoxi District, Shijiazhuang, 050051, Hebei Province, China. Electronic
address: dr_yzzhang@126.com.
OBJECTIVE: To compare the clinical outcomes of negative-pressure wound therapy
(NPWT) versus conventional therapy on split-thickness skin after grafting
surgery.
DESIGN: Meta-analysis.
BACKGROUND: Split-thickness skin grafts are widely used in reconstruction of
large skin defects. Conventional therapy causes pain during dressing changing.
NPWT is an alternative method to cover the wound bed.
METHODS: The Pubmed, Embase, and Cochrane databases were searched for randomized
controlled trials (RCTs) or cohort studies for articles published between 1993
and April 2017 comparing NPWT to conventional wound therapy for split-thickness
skin grafts. The rate of graft take was the primary outcome of this
meta-analysis. Wound infection and reoperation rate of the wound were secondary
outcomes. Data analysis was conducted using the Review Manager 5.3 software.
RESULTS: Five cohort studies and seven RCTs including 653 patients were eligible
for inclusion. Patients treated with NPWT had a significantly higher rate of
graft take compared to those treated with conventional therapy [MD = 7.02, (95%
CI 3.74, 10.31)] (P = .00). NPWT was associated with a reduction in reoperation
[RR = 0.28, (95% CI 0.14, 0.55)] (P = .00). The reduction in wound infection was
not significant [RR = 0.63, (95% CI 0.31, 1.27)] (P = .20).
CONCLUSION: Compared with conventional therapy, NPWT significantly increases the
rate of graft take and reduces the rate of reoperation when applied to cover the
wound bed with split-thickness skin graft. No significant impact on wound
infection was found in this study.
Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights
reserved.
DOI: 10.1016/j.ijsu.2017.12.020
PMID: 29292216
