To the editor,
We would like to thank Farina and colleagues for their letter to the editor regarding our systematic literature review of negative pressure wound therapy in Grade IIIB tibia fractures. We agree that through the years, a traditional reconstructive ladder has been formulated. As they stated, this ladder is “a paradigm that helps to inform the choice of closure method across an array of defects.”
The advent of negative pressure wound therapy has added a new dimension to the reconstructive ladder. We thank you for sharing two challenging cases that you were able to treat in a simpler manner using skin grafts rather than free flaps. That has been our clinical experience as well, and of others as noted in our review paper. There are select patient situations whereby negative pressure wound therapy will move the final skin closure and bone coverage method down the reconstructive ladder. We agree that more research is needed to identify these patients and as you stated, “simplify surgical management, decrease the frequency of infections, and reduce cost.”
Footnotes
(RE: Schlatterer DR, Hirschfeld AG, Webb LX. Negative Pressure Wound Therapy in Grade IIIB Tibial Fractures: Fewer Infections and Fewer Flap Procedures? Clin Orthop Relat Res. 2015;473:1802–1811).
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The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR ® or The Association of Bone and Joint Surgeons®.