154 - Single-stage Biomatrix and Skin Graft Technique Utilizing a Portable Negative Pressure Wound Therapy (NPWT) Device Decreases Hospital Costs for a Single-stage Biomatrix and Skin Graft Technique
Clinical Issue: We assess the economic savings when using a single-stage, single-patient NPWT* system over an advanced biomatrix** and skin graft for accelerating the wound healing process by avoiding a second operation and evaluating ease of transition from inpatient to outpatient status. Advanced biomatrix* is normally performed as a 2-stage procedure, with one operation to place the biomatrix*, and then another performed in 3 weeks for the STSG. We demonstrate our technique and results in 10 consecutive patients. Description of Team: Charles K Lee, MD; Nakyung Kim, MD; Gina Restani, ORT; Tina Lin, RNPreparation and Planning: We demonstrate our technique and results in 10 consecutive patients. Biomatrix***, STSG, and NPWT* (-125mmHg) were utilized in patients for complex radial forearm free flap donor site reconstruction in a single-stage procedure. Assement: We assessed the cost stemming from the single stage-procedure versus the standard 2-stage procedure. Outcome /
Results: Patients treated with the single-stage biomatrix, STSG, and NPWT therapy were all discharged on postoperative day 5. They were easily transitioned from the inpatient status to the outpatient/home setting and had the NPWT device removed in 10-14 days. Mean graft take was 98% with no infections. A second operation was not necessary for the STSG and there was no delay in discharge. The cost of the second STSG operation, ($10,000) and potential 1-2 days in hospital for discharge ($1500/day) was avoided. Implications for Perioperative Nursing: Single-stage biomatrix***, STSG, and NPWT* results in successful reconstruction of large, complex radial forearm free flap donor sites used in phalloplasty. Using the portable, single-patient NPWT device allows for easy discharge of the inpatient and avoids a costly, second operation to place a STSG. The single-stage procedure can be considered a superior, cost-effective alternative to the current 2-stage procedure. Patient satisfaction is greatly increased by avoiding secondary operation and hospital stay without sacrificing quality of care.
Disclosure(s): Charles Lee - Medela - Employee and Consultant/Speakers' Bureau