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


Por: Vélez-Palafox M., Ponce-Damián L.D., Márquez-Gutiérrez E.A., González-Torres M.

Publicada: 1 ene 2025
Resumen:
Background: 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. Methods: 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. Results: 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. Conclusions: 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. © 2025

Filiaciones:
Vélez-Palafox M.:
 Division Head of Plastic and Reconstructive Surgery, National Center for Research and Care of Burns, National Institute of Rehabilitation, Mexico City, Mexico

 National Autonomous University of Mexico, Graduate Studies Division, Faculty of Medicine, Mexico City, Mexico

Ponce-Damián L.D.:
 Division of Plastic and Reconstructive Surgery, National Center for Research and Care of Burns, National Institute of Rehabilitation, Mexico City, Mexico

Márquez-Gutiérrez E.A.:
 Division of Plastic and Reconstructive Surgery, National Center for Research and Care of Burns, National Institute of Rehabilitation, Mexico City, Mexico

González-Torres M.:
 Departamento de Ciencias Químicas, Facultad de Estudios Superiores Cuautitlán-UNAM, Avenida 1ro. de Mayo s/n C.P., Cuautitlán Izcalli, Estado de México, 54740, Mexico
ISSN: 00201383
Editorial
Elsevier Ltd, THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND, Reino Unido
Tipo de documento: Article
Volumen: 56 Número: 5
Páginas:
WOS Id: 001509684400001
ID de PubMed: 40222842