T Anniboletti, M Palombo, S Moroni, P Palombo. Burn Center, S.Eugenio Hospital, Rome, Italy

1. NEGATIVE PRESSURE WOUND THERAPY : IS THE
ROUTINELY APPLICATION POSSIBLE IN BURNS?
T Anniboletti, M Palombo, S Moroni, P Palombo.
Burn Center, S.Eugenio Hospital, Rome, Italy
EP 430
As an alternative to free tissue transfer, we used the Vacuum Assisted Closure therapy in
combination with unmeshed split thickness skin grafts (STSG) to improve the skin graft
take for the reconstruction with and without the use of dermal substitutes Matriderm ™
and Integra ™
EVALUATION CRITERIA:
- Burn surface area
- Burn degree
- The application or not of the
dermal substitute
- NPWT treatment period of a
minimum of 6 days
- Final outcome
Clinical study: 27 patients with burns or acute high-voltage injuries

2. NPWT was applied on 27 patients aged between 21 and 76 years old,
average age 46,1.
- With MATRIDERM was applied on 13 patients aged between 32 years
and 76 years old, average age 52,7.
- With INTEGRA dermal regeneration template Single Layer was applied
on 7 patients aged between 6 years and 76 years old, average age 36,2.
- Without dermal substitutes was applied on 7 patients
Results
All patients were treated with burn wounds escharectomy and immediate
application of the negative pressure wound therapy with or without the
use of the dermal substitute and then STSG.

3. In the 7 patients treated with escharectomy and NPWT application,
after a period of 6-13 days (average 9,4) a clear increase of the
granulation tissue was observed and a split thickness skin graft
was applied
0
5
10
15
1 2 3 4 5 6 7
Time of NPWT
Days of
NPWT
Patients treated with STSG+NPWT
Days
The NPWT, increasing the blood circulation, improves
the skin graft take and decreases the healing time
Results

4. Wound check at 7 post operative days
• Complete skin graft take: 7 patients
• Partial skin graft take: 5 patients
• Complete failure of the procedure: 1 case
Patients treated with immediate application of Matriderm,
unmeshed STSG and NPWT
Results

5. Patients treated with immediate application of Integra,
unmeshed STSG and NPWT
Wound check at 7 post operative days
• Complete skin graft take: 3 patients
• Partial skin graft take: 2 patients
• Complete failure of the procedure: 2 cases
Results
The Negative Pressure Wound Therapy was well tolerated by all patients.
Final graft take at 8 days after the split thickness skin graft application was
from 85 to 100 per cent with an average of 91.3 per cent.

6. In patients with severe burns (high burned TBSA) we tried to apply
NPWT by the time the presentation in the emergency room at a
pressure of 70 mmHg.
- useful for the reduction of local edema, infection control and
preparation of the graft recipient bed.
- most important limitation, however, has been the difficulty to apply ,
the time and often the inability of the film to adhere (without or
with little healthy skin surfaces exudating).

7. • woman, 22 yo
• burned 60%TBSA
• presentation in the emergency room

8. • woman, 22 yo
• NPWT 1st day
• cadaver skin graft and autograft
In our center is used for all
IInd deep and IIIrd burns
in which there is a good margin of healthy skin
In patients with severe burns (high burned TBSA) we tried to apply
NPWT by the time the presentation in the emergency room at a
pressure of 70 mmHg.
- useful for the reduction of local edema, infection control and
preparation of the graft recipient bed.
- most important limitation, however, has been the difficulty to apply ,
the time and often the inability of the film to adhere (without or
with little healthy skin surfaces exudating).