Acceleration of Integra incorporation in complex tissue defects with subatmospheric pressure.

In an effort to accelerate vascularization and simplify the care of Integra (Ethicon, Inc., Somerville, N.J.), topical subatmospheric pressure was used for eight patients (age range, 2 to 60 years) with complex wounds. Bone was exposed in 62.5 percent of cases, joint in 50 percent, tendon in 37.5 percent, and bowel in 25 percent. The estimated Integra take rate was 96 percent. Split-thickness skin grafting was performed at 4 to 11 days (mean, 7.25 days), with a 93 percent take rate. No adverse side effects were observed with this technique. Application of subatmospheric pressure improved the take rate and time to vascularization of Integra, compared with previous published results, even with complicated wounds. This technique may be a practical alternative to flap closure.