Neck reconstruction in burn sequelae: A comparison of full-thickness skin grafts with traditional tie-over versus negative pressure wound therapy for both recipient site preparation and graft fixation
Year: 2025
Type: article
Abstract: • This study compares traditional tie-over fixation with NPWT for full-thickness skin grafts (FTSGs) in neck reconstruction. • Unlike previous studies, NPWT was used not only for graft fixation but also for recipient site preparation prior to grafting. • This dual application resulted in improved graft integration, lower necrosis rates, and shorter hospital stays compared to the traditional tie-over technique. Neck reconstruction for burn sequelae can be effectively achieved through release procedures and lower abdomen skin transplantation. This article describes cases in which full-thickness skin grafts (FTSGs) from the lower abdomen were used as donor areas. Although the benefits of negative pressure wound therapy (NPWT) for graft integration are known, its dual use for recipient site preparation and intraoperative graft fixation, specifically in the neck, has been scarcely described. This study evaluates both applications of NPWT—preoperative wound bed optimization and intraoperative graft fixation—highlighting their combined impact on graft take and patient outcomes. Patients treated at a referral burn center between March 2021 and October 2023 with severe neck contractures underwent scar release and FTSG transplantation. Two techniques for graft fixation were compared: the traditional tie-over method and NPWT. Graft integration rates, necrosis percentages, and postoperative complications were assessed. The study included six patients (tie-over group: 2; NPWT group: 4). The NPWT group demonstrated clinically favorable graft integration rates (92.5 %) and lower necrosis rates (7.5 %) compared with the tie-over group (76.5 % and 23.5 %, respectively). The NPWT technique also resulted in shorter hospital stays and fewer complications. The combined use of NPWT for recipient site preparation and intraoperative graft fixation clinically improves graft integration and reduces complications in neck burn reconstruction. These findings suggest that NPWT should be considered a standard of care in settings where resources allow.
Source: Injury
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,640
OpenAlex ID: W4409387543