Use of a Novel Silicone-Acrylic Drape with Negative Pressure Wound Therapy to Bolster Skin Grafts and Flaps
Traditionally, negative pressure wound therapy (NPWT*) has utilized an adhesive acrylic drape† to cover the foam dressing and create a seal. However, removal of this drape can be painful. A novel silicone-acrylic hybrid drape‡ has been developed for use with NPWT to allow for re-positioning upon initial placement and easier removal. This three-patient case study reports on the use of the silicone-acrylic hybrid drape with NPWT as a bolster over skin grafts or flaps in four wounds. Following wound closure with skin grafts or flaps, NPWT was applied as a bolster using the silicone-acrylic hybrid drape and negative pressure of -125 mmHg. A non-adherent protective layer was applied over the skin grafts before the NPWT dressing was applied. Two males and 1 female received NPWT following the skin graft (n=3) or skin flap (n=1) procedure over 4 wounds (hand, right lower extremity, right calf, and right medial thigh). Common patient comorbidities included tobacco use, coronary heart disease, peripheral vascular disease, obesity, and diabetes. NPWT was used for a total of 7 days. Patient pain was assessed after drape removal using the visual analog scale. The patient reported pain averaged 1 (range 0-2) on a 10-point scale. All skin grafts and flaps showed complete take without any complications. Use of the silicone-acrylic hybrid drape with NPWT supported graft and flap take and resulted in little to no pain in these 3 patients.
*V.A.C.® Therapy, †V.A.C.® Drape; ‡V.A.C. DERMATAC™ Drape; KCI, now part of 3M Company, San Antonio, TX