Work

Modified C-shaped negative pressure wound therapy for skin graft fixation on digits: A case report

Year: 2026

Type: article

Abstract: Application of negative pressure wound therapy (NPWT) to the digits is often limited by anatomical constraints, including a cylindrical contour, restricted sealing surface, and the need to preserve finger mobility. Although NPWT is beneficial for wound stabilization and skin graft fixation, practical techniques for digital application remain insufficiently described. A 56-year-old woman presented with a 10-year history of longitudinal melanonychia of the left index fingernail. Because of multiple concerning features, slow Mohs micrographic surgery was performed, and histopathology confirmed acral lentiginous melanoma in situ with clear margins. Reconstruction was achieved using a full-thickness skin graft harvested from the ipsilateral groin. To stabilize the graft, NPWT was applied at a continuous pressure of –140 mmHg using a modified polyurethane sponge. The sponge was shaped into a hollow C-shaped configuration with oblique trimming, allowing the digit to be positioned without circumferential compression. This configuration enabled uniform negative pressure distribution while preserving finger mobility. NPWT was maintained for 16 days with regular dressing changes, and the graft demonstrated stable take without complications. This modified C-shaped NPWT technique provides a practical solution for graft stabilization in anatomically challenging digital wounds and may facilitate broader use of NPWT in digital reconstruction while preserving function.

Source: JAAD Case Reports

DOI: 10.1016/j.jdcr.2026.08.044

Authors: Han Seong Yoon, Hoon Choi, Chan-Ho Na, Bong Seok Shin, Min Sung Kim

Institutions: Chosun University, Chosun University Hospital

Language: English

Topic: Wound Healing and Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $750