What is the optimal dressing for securing a split-thickness skin graft? A systematic review and meta-analysis of the studies comparing NPWT with traditional dressings
Bibliographic record
Abstract
BackroundSplit-thickness skin grafts (STSG) are commonly employed for repairing significant skin defects. Traditional aftercare typically involves applying a protective layer of petroleum and cotton gauze dressing. Nonetheless, this conventional approach to securing and protecting the skin graft is frequently cumbersome and not very effective. Negative-pressure wound therapy (NPWT) has emerged as a promising alternative method for dressing split-thickness grafts, offering a more efficient solution.MethodsA systematic review of studies comparing STSG dressing methods was performed. The Medline/Pubmed, Embase, Scopus, Cochrane Library, and Web of Science databases were thoroughly searched. The data concerning graft take percentage, reoperation rate, and complication (infection, seroma, hematoma) rates were extracted. The Cochrane risk-of-bias tool was used for randomized studies, while Newcastle-Ottawa Quality Assessment for Cohort Studies was used for other types of research. Statistical analysis was conducted with PS IMAGE PRO 9.0 (IBM SPSS Statistics 29.0) software.ResultsOur meta-analysis included 29 studies (14 randomized and 15 non-randomized), comprising a total of 2,025 patients. No study was excluded because of its poor quality. We observed a significantly higher percentage of graft take in the group of patients treated with NPWT when compared to those treated with conventional therapy (standardized mean difference (SMD) = 1,34% (95% CI: 0,62-2,07%; p<0,01)). NPWT was associated with a reduction in reoperation rate (OR = 0,29 (95% CI: 0,17-0,50; p<0,01)), a reduction in graft infection rate (OR = 0,37 (95% CI: 0,24-0,58; p<0,01)), and a reduction in seroma formation rate (OR = 0,38 (95% CI: 0,15-0,93; p = 0,03)). The reduction in hematoma formation rate was not statistically significant (OR = 0,64 (95% CI: 0,33-1,22; p = 0,17)).ConclusionsWhen contrasted with traditional treatment methods, negative-pressure wound therapy (NPWT) notably enhances the success rate of grafting and lowers the need for additional surgeries when utilized for split-thickness skin grafting. Additionally, NPWT decreases the risk of wound infection and seroma formation under the graft, which improves the healing process of the graft’s recipient site.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.010 | 0.005 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".