Abstract
EVALUATING THE EFFICACY OF NEGATIVE-PRESSURE WOUND THERAPY WITH DAKIN’S SOLUTION INSTILLATION VERSUS CONTINUOUS NEGATIVE-PRESSURE WOUND THERAPY: A FOCUS ON WOUND SITE INFECTION AND SPLIT SKIN GRAFT OUTCOMES

*Dr. Amira Al-Saad, Dr. Tariq Al-Majid, Dr. Laila Nasser and Dr. Rohan Deshpande

ABSTRACT

This non-randomized controlled trial evaluated the efficacy of Dakin's solution-enhanced Negative-Pressure Wound Therapy (D-NPWT) compared to Continuous NPWT (C-NPWT) in enhancing split thickness skin graft (STSG) survival and reducing wound site infections. A total of 100 patients (65 men, 35 women) undergoing lower extremity grafting were enrolled and divided into two groups: D-NPWT (n=50) and C-NPWT (n=50). The D-NPWT group received NPWT with intermittent Dakin's solution cleansing, while the C-NPWT group underwent continuous NPWT. Baseline characteristics, including age, gender, wound type, and size, were recorded. The primary outcome measured was STSG survival, calculated using a predefined formula, and categorized into Excellent, Good, Moderate, Poor Graft Take, and Graft Failure. Wound site infection was assessed clinically. The D-NPWT group showed significantly higher rates of Excellent Graft Take (96%) compared to the C-NPWT group (60%, p < 0.001). Good Graft Take was observed in 4% of the D-NPWT group and 30% of the C-NPWT group. There were no instances of Moderate or Poor Graft Take in the D-NPWT group, while the C-NPWT group had 10% Moderate Graft Take and no Poor Graft Take. Graft failure was absent in the D-NPWT group but occurred in 10% of the C-NPWT group. The incidence of wound site infection was significantly lower in the D-NPWT group (4%) compared to the C-NPWT group (24%, p < 0.05). The D-NPWT group also demonstrated superior average graft survival rate (mean: 96.25%, SD: 4.46%) relative to the C-NPWT group (mean: 69.52%, SD: 11.08%, p < 0.05). The study demonstrates that D-NPWT significantly improves STSG survival and reduces wound site infections compared to Continuous NPWT, suggesting that Dakin's solution is a valuable adjunct in wound therapy protocols.

Keywords: Antiseptic Solutions, Dakin's Solution, Negative-Pressure Wound Therapy, Skin Graft Survival, Split Skin Grafts, Wound Healing, Wound Infection.


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