Putu Tasha Siorcani, Agus Roy Rusly Hariantana Hamid

- Negative pressure wound therapy versus tie-over as bolster for split-thickness skin grafts in burn wounds: a systematic review

Introduction

- negative pressure wound therapy versus tie-over as bolster for split-thickness skin grafts in burn wounds: a systematic review. Systematic review reveals Negative Pressure Wound Therapy (NPWT) outperforms tie-over for securing split-thickness skin grafts in burn patients, enhancing graft survival and reducing complications.

Abstract

Introduction: Securing a split-thickness skin graft (SSG) is critical for successful healing in burn patients. Traditional tie-over bolster dressings and Negative Pressure Wound Therapy (NPWT) are two primary methods used for graft fixation, but their comparative efficacy remains a topic of clinical interest. This systematic review aims to critically appraise and synthesize the available comparative evidence on the efficacy and safety of NPWT versus the conventional tie-over dressing for securing SSGs in patients with burn wounds. Method: A systematic search was conducted on the PubMed, ScienceDirect, and Scopus databases for studies published between 2015 and 2025. Comparative studies involving human subjects with burn wounds treated with SSG, which directly compared NPWT to a tie-over bolster, were included . The primary outcomes of interest were graft take rate, post-operative complications, and length of hospital stay. Results: From an initial 231 records, three studies met the inclusion criteria after screening and were included in the qualitative synthesis. The three included studies consistently reported that NPWT was associated with a statistically significant improvement in graft take or survival rate compared to the tie-over dressing . Furthermore, the use of NPWT was linked to a significant reduction in post-operative complications, including partial graft loss, infection, and hematoma, as well as a shorter duration of post-operative hospital stay. Conclusion: The evidence reviewed consistently supports the use of NPWT as a superior method for securing split-thickness skin grafts in burn patients. Compared to the traditional tie-over technique, NPWT leads to better graft survival, fewer complications, and a more efficient recovery.

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