Comparison of negative pressure wound therapy and wet-to-dry dressing after fasciotomy in earthquake victims: A retrospective cohort study.

backgroundThis study aimed to compare the clinical effectiveness of negative pressure wound therapy (NPWT) with traditional wet-to-dry dressings in patients undergoing fasciotomy for acute compartment syndrome of the lower extremities following the February 6, 2023 earthquakes in Kahramanmaraş, Türkiye.

methodsThis retrospective cohort study included 28 patients (15 males, 13 females) admitted to our hospital between February 6 and March 6, 2023, who underwent fasciotomy for lower extremity acute compartment syndrome. A total of 109 fasciotomy incisions were performed across 60 extremities. Of these, 78 wounds were managed with NPWT and 31 with wet-to-dry dressings. Group allocation was determined by NPWT device availability during the disaster period. All patients were managed using a standardized wound closure protocol, including serial debridement followed by primary closure or split-thickness skin grafting when indicated. Outcomes compared between groups included number of debridements, infection rate, primary wound closure, graft requirement, dressing-related complications, and length of hospital stay.

resultsThe NPWT group required significantly fewer debridements (p<0.05). Dressing-related complications and the need for additional dressing interventions were significantly higher in the wet-to-dry group (p<0.05). No significant differences were observed between groups in infection rate, primary wound closure, graft requirement, or length of hospital stay (p>0.05). Among pediatric patients, infection rates were lower than in adults, whereas unplanned dressing changes were significantly more frequent (p<0.05).

conclusionNPWT is an effective wound management modality in fasciotomy patients, even under disaster conditions. It significantly reduced the need for debridement and dressing-related complications compared to traditional methods, despite similar outcomes in infection and wound closure. These findings support the preferential use of NPWT in mass-casualty settings, where healthcare personnel and resources may be limited. In addition to its clinical benefits, NPWT offers logistical advantages by simplifying wound care and reducing healthcare workload. Future prospective, randomized, multicenter studies are needed to confirm these findings and evaluate the broader applicability and cost-effectiveness of NPWT in both disaster and routine clinical settings.