Facilitating residual wound closure after partial graft loss with vacuum assisted closure therapy. |
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Authors: | Stathis Poulakidas Areta Kowal-Vern |
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Institution: | Department of Trauma, Hospital of Cook County, Chicago, Illinois, USA. |
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Abstract: | Third degree burns require skin grafting. In most instances, if the graft becomes infected, it requires debridement of the site and re-grafting. The purpose of this report is to illustrate the successful healing of a skin graft using negative pressure wound therapy with silver impregnated foam and soft silicone wound contact layer in a 4% total body surface area burn of a lower extremity skin graft infected with Pseudomonas aerugenosa without regrafting. A 27-year-old Hispanic male sustained a gasoline flame burn and presented 72 hours postincident with right lower extremity cellulitis. After intravenous antibiotics, the area was grafted with a partial thickness sheet graft. At 9 days postoperatively, the patient developed a wound infection, with an eventual 40% graft loss and was started on a course of antibiotics. With continued graft loss, on the 22nd postoperative day, negative pressure wound therapy V.A.C. (Vacuum Assisted Closure-KCI, San Antonio, TX) with silver impregnated foam and soft silicone wound contact layer (Mepitel, Molnlycke Health Care, Gothenburg, Sweden) were applied. The wound was completely re-epithelialized by 9 days. In combination with antibiotics, it was possible to treat a residual open wound and prevent the need for regrafting. |
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