Comparison of Negative Pressure Dressing and Conventional Pressure Dressing for Management of Fibula Free Flap Donor Site in Head and Neck Reconstruction

Abstract

Background : The fibula free flap is a useful option in head and neck reconstructive surgery. The donor site is often closed with skin grafts. There have been some reports describing skin grafts fixed by negative pressure dressing ( NPD ) instead of conventional pressure dressing and splint ( CPD ). Methods : Between 2007 and 2015, 56 fibula flap donor sites were covered with split-thickness skin grafts immobilized with either CPD ( n=42 ) or NPD ( n=14 ). We evaluated the operating time, postoperative walking rehabilitation day, wound complications ( graft take rate, infection ), re-operation for donor, length of hospital stay, healing time and total treatment costs in the hospital. Results : There were no significant differences in median operating time, graft take rate, donor infection, median length of hospital stay or healing time between the two groups. Median postoperative walking rehabilitation day was day 7 and day 4 for CPD and NPD, respectively; the difference was significant. However, CPD was found to be significantly more cost efficient than NPD. Conclusion : There was no significant difference in the outcomes in relation to wound healing. The NPD group demonstrated the benefits of early ambulation improvement, although the treatment is expensive.