Extra-large negative pressure wound therapy dressings for burns - Initial experience with technique, fluid management, and outcomes

Burns : Journal of the International Society for Burn Injuries
Sebastian FischerEric G Halvorson

Abstract

The use of negative-pressure-wound-therapy (NPWT) is associated with improved outcomes in smaller burns. We report our experience using extra-large (XL) NPWT dressings to treat ≥15% total body surface area (TBSA) burned and describe our technique and early outcomes. We also provide NPWT exudate volume for predictive fluid resuscitation in these critically ill patients. We retrospectively reviewed patients treated with XL-NPWT from 2012 to 2014. Following excision/grafting, graft and donor sites were sealed with a layered NPWT dressing. We documented wound size, dressing size, NPWT outputs, graft take, wound infections, and length of stay (LOS). Mean NPWT exudate volume per %TBSA per day was calculated. Twelve burn patients (mean TBSA burned 30%, range 15-60%) were treated with XL-NPWT (dressing TBSA burned and skin graft donor sites range 17-44%). Average graft take was 97%. No wound infections occurred. Two patients had burns ≥50% TBSA and their LOS was reduced compared to ABA averages. XL-NPWT outputs peaked at day 1 after grafting followed by a steady decline until dressings were removed. Average XL-NPWT dressing output during the first 5 days was 101±66mL/%BSA covered per day. 2 patients developed acute kidney injury. The u...Continue Reading

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Citations

Jul 6, 2016·Burns : Journal of the International Society for Burn Injuries·Neelesh A KantakEric G Halvorson
Mar 30, 2017·Archives of Plastic Surgery·Zhi Yang NgHarvey Wei Ming Chim
Jan 6, 2021·International Journal of Surgery Case Reports·Raul Cuevas BustosMarcos Jafif Cojab

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