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The positive effect of negative pressure: vacuum-assisted fixation of Integra artificial skin for reconstructive surgery


Stiefel, D; Schiestl, C M; Meuli, M (2009). The positive effect of negative pressure: vacuum-assisted fixation of Integra artificial skin for reconstructive surgery. Journal of Pediatric Surgery, 44(3):575-580.

Abstract

BACKGROUND: Integra artificial skin (Integra) (Integra Life Sciences Corporation, Plainsboro, NJ) is increasingly used as a skin substitute in reconstructive surgery. However, reliable fixation to the wound bed, a factor of paramount importance for successful application, is often hard to achieve. The vacuum-assisted closure system (VAC; KCI, Switzerland), a well-established subatmospheric pressure device, might be of interest to overcome these problems because of its ability to conform to almost any surface. The goal of this study was to test whether negative pressure application yields reliable fixation of Integra in children undergoing reconstructive surgery. METHODS: Between 2001 and 2004, VAC was applied in 18 children (n = 18) aged 7 months to 16.5 years. All required reconstructive surgery with implantation of Integra covering 1% to 12% of the total body surface area. After Integra implantation, VAC was installed for 13 to 30 days. RESULTS: The VAC fixation of Integra was successful in 17 patients (94.5%). The only failure (5.5%) occurred in a patient in whom negative pressure could not be maintained because of a lesion site susceptible to both dislodgement and infection (perianal region). Consequently, infection occurred, and Integra had to be removed. CONCLUSIONS: These results demonstrate that VAC is a valid tool for reliable fixation of Integra in children undergoing even demanding reconstructive surgery.

BACKGROUND: Integra artificial skin (Integra) (Integra Life Sciences Corporation, Plainsboro, NJ) is increasingly used as a skin substitute in reconstructive surgery. However, reliable fixation to the wound bed, a factor of paramount importance for successful application, is often hard to achieve. The vacuum-assisted closure system (VAC; KCI, Switzerland), a well-established subatmospheric pressure device, might be of interest to overcome these problems because of its ability to conform to almost any surface. The goal of this study was to test whether negative pressure application yields reliable fixation of Integra in children undergoing reconstructive surgery. METHODS: Between 2001 and 2004, VAC was applied in 18 children (n = 18) aged 7 months to 16.5 years. All required reconstructive surgery with implantation of Integra covering 1% to 12% of the total body surface area. After Integra implantation, VAC was installed for 13 to 30 days. RESULTS: The VAC fixation of Integra was successful in 17 patients (94.5%). The only failure (5.5%) occurred in a patient in whom negative pressure could not be maintained because of a lesion site susceptible to both dislodgement and infection (perianal region). Consequently, infection occurred, and Integra had to be removed. CONCLUSIONS: These results demonstrate that VAC is a valid tool for reliable fixation of Integra in children undergoing even demanding reconstructive surgery.

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20 citations in Web of Science®
28 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:01 Mar 2010 13:24
Last Modified:05 Apr 2016 13:55
Publisher:Elsevier
ISSN:0022-3468
Publisher DOI:10.1016/j.jpedsurg.2008.07.006
PubMed ID:19302862

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