Vacuum-sealing fixation of mesh grafts

Between 1994 and 2001 we used the vacuum-sealing technique in 478 skin grafts. Indications included large soft-tissue defects resulting from trauma, skin loss due to degloving injuries, burns, and infected/contaminated wound surfaces. The technique involves direct placement of the white polyvinyl alcohol pad directly onto the transplanted skin. The necessary negative pressure is generated by redon flasks yielding a negative pressure of 60–80 kPa (high-pressure system). In extensive wounds a vacuum pump is used. The high pressure used does not result in necrosis. In 11 patients poor wound conditions resulted in only partial healing. Three patients with pseudomonas infections experienced complete loss of the graft. The vacuum-sealing technique permits a moderate moist and warm wound treatment with stable fixation of the transplant even in cases of large wounds or those with irregular contours. The method is not suitable in cases of infection or contamination with pseudomonas species.