Background: Burns represent one of the most devastating
modes of trauma with significant morbidity and mortality.
Despite advances in burns care, infection remains one of the
leading causes of death. Burn excision is mandatory in infected
cases and need to be temporarily covered with allografts,
however this is not available in many settings. Negative
pressure wound therapy (NPWT) has become an integral part
of wound management, and is being used in burns with
different indications.
Objective: The use of NPWT as a temporary coverage
after excision of infected burns for wound bed preparation
before autografting, and to compare the outcomes with those
of early excision and grafting.
Patients and Methods: Ten patients with 15 burn wounds
were allocated to 2 groups; group A patients presented late
with infected burns while group B presented early. Group A
had excision followed by NPWT and autografting when ready,
and Group B had early excision and grafting. Both groups'
outcomes were compared in terms of wound size, graft take
and laboratory markers.
Results: Both groups included different mechanisms of
burns, various age groups, total burn surface area (TBSA) up < br />to 30%. Most Group A patients had a reduction of wound size
(mean 5.1%) with using NPWT, and the average graft take
was 83.9% and 85% for Group A and Group B respectively.
Inflammatory markers were reduced in Group A patients,
who also showed an increase in serum albumin compared to
Group B.
Conclusions: NPWT should be considered for temporary
coverage after excision of infected burns before autografting.
It may minimize the size of the wound, and can increase graft
take that can be comparable to cases excised and grafted early.
Further work is needed to assess NPWT against allografts in
infected burns, and to investigate its use with early excision.