Evaluation Of Hospital Stay Duration In Post-Traumatic Wound Patients After Negative Pressure Versus Conventional Dressings : An Observational Comparative Study.

Abstract

Introduction: Split-thickness skin grafting is a widely used technique for post-traumatic wound management, however it may get complicated by delayed wound healing which leads to a considerable burden on patient and healthcare services in terms of increased treatment duration, costs and disability rates. One factor that may promote wound healing is the type of dressing applied over the skin graft. The use of negative pressure wound therapy over conventional dressings seems promising but evidence remains uncertain.

Aims and Objectives: To compare the duration of hospital stay after negative pressure versus conventional dressings on skin graft for post-traumatic wound management.

Materials and Methods: A prospective observational comparative study was conducted on 60 patients at a tertiary trauma care hospital. Patients with post-traumatic wounds awaiting skin grafting were included in the study.They were then divided into two equal groups on the basis of odd/even hospital registration number. Dressing was applied after the operative procedure, in a conventional way (Group CD) and by negative pressure technique (Group NPD). Graft take up evaluated on day 4, 7 & 10. The length of hospital stay and complications were noted from the discharge pro-forma. The data was analysed using SPSS software.

Results: Demographic profile, size and site of wound area of two groups were comparable (p>0.05). The graft take up was much higher in groups NPD vs CD (p<0.05). Duration of hospital stay was statistically lower in group NPD vs CD (2.3±1.92 vs 5.6±4.23) (P=0.000). Complications such as infection and seroma formation were observed in 10% of patients in group CD.

Conclusion: Negative pressure wound therapy provides better skin graft take up, shorter hospital stay and lesser complication rate over conventional method of dressing after grafting. Larger RCTs are recommended to prove effectiveness of this technique.