Study finds similar graft outcomes with VAC or standard bandaging
Bottom line
A new retrospective JAVMA study of 125 dogs found no significant difference in outcomes when free meshed full-thickness skin grafts were managed with vacuum-assisted closure (VAC) versus standard bandaging (SB). The review covered cases from a single private practice between January 2012 and December 2025 and included dogs with at least 14 days of follow-up. The authors also evaluated splinted versus staged graft cases and reported no meaningful difference there, suggesting the choice of postoperative dressing method may not be the main driver of graft success in this cohort. (vetlit.org)
Why it matters: VAC or negative-pressure wound therapy has often been viewed as a helpful adjunct for graft adherence and wound-bed management, and prior veterinary literature has suggested benefits in smaller or experimental cohorts. But this larger retrospective dataset points to a more pragmatic takeaway for veterinary teams: if standard bandaging is performed well, outcomes may be comparable, which could matter for case cost, equipment access, troubleshooting, and client communication with pet parents. It also reinforces that wound-bed preparation, immobilization, bandage management, and follow-up may matter at least as much as the dressing system itself. (pmc.ncbi.nlm.nih.gov)
What to watch: Prospective, multicenter studies that control for wound type, graft location, surgeon technique, and case selection will be important to clarify whether any subgroup of dogs benefits more from VAC than from standard bandaging. (pmc.ncbi.nlm.nih.gov)
Key facts
- Study type
- Retrospective JAVMA study
- Sample size
- 125 dogs
- Procedure
- Free meshed full-thickness skin grafting
- Comparison
- Vacuum-assisted closure versus standard bandaging
- Main finding
- No significant difference in outcomes
- Secondary comparison
- No significant difference between splinted and staged cases
- Study setting
- Single private practice
- Study period
- January 2012 to December 2025
- Follow-up
- At least 14 days
A retrospective study published in JAVMA reports that, in a cohort of 125 dogs undergoing free meshed full-thickness skin grafting, outcomes did not differ significantly between cases managed with vacuum-assisted closure and those managed with standard bandaging. The authors also found no significant difference between splinted and staged cases, adding to the discussion around how much postoperative dressing choice influences graft success in routine clinical practice. (vetlit.org)
That finding matters because VAC, also called negative-pressure wound therapy, has built a strong reputation in both human and veterinary wound care. Reference sources and clinical reviews describe potential advantages including fluid removal, reduced bacterial burden, improved granulation tissue formation, and better graft stabilization. In veterinary surgery, it has been used not only for open wound management, but also to secure skin grafts and support revascularization during the early postoperative period. (merckvetmanual.com)
Earlier veterinary evidence has generally been favorable to VAC, but it has also been limited. An experimental 2013 study in dogs reported improved healing variables and less necrosis with negative-pressure wound therapy over free full-thickness grafts, and the authors said the modality had become standard of care at their teaching hospital. A 2017 retrospective case series using polyvinyl alcohol foam to bolster full-thickness mesh skin grafts in eight dogs also described good graft acceptance, though that study lacked a standard-bandaging comparison group and was small. (pmc.ncbi.nlm.nih.gov)
Against that backdrop, the new JAVMA paper stands out for its larger clinical sample size and real-world case mix. Based on the abstracted report, the investigators reviewed records from January 2012 through December 2025 at a single private practice and included dogs treated with either VAC or standard bandaging that had at least 14 days of follow-up. They collected signalment and comorbidity data and compared graft-related outcomes across treatment groups, while also examining whether splinted and staged approaches performed differently. The headline result was a lack of significant difference, which suggests that the practical benefits often attributed to VAC may not always translate into superior measurable outcomes across a broad referral caseload. (vetlit.org)
Outside this paper, the broader literature gives some context for why the result may resonate with clinicians. Clinical guidance for free skin grafts emphasizes that meticulous wound-bed preparation, postoperative immobilization, bandage care, and activity restriction are central to graft survival. Merck’s veterinary reference on negative-pressure wound therapy also notes that one of the hardest parts of VAC use in veterinary patients is simply maintaining an airtight seal, a practical limitation that can affect case selection, labor, and cost. That may help explain why a technique with sound biologic rationale does not automatically outperform standard bandaging in every practice setting. (cliniciansbrief.com)
Why it matters: For veterinary professionals, this study may support a more selective approach to VAC rather than assuming it should be the default for every free meshed full-thickness skin graft. If standard bandaging can deliver similar outcomes in many dogs, teams may have more flexibility when balancing equipment availability, hospitalization demands, technical expertise, and what pet parents can realistically pursue. It also gives surgeons firmer footing for discussing expectations: success may depend less on the brand or complexity of the dressing and more on case selection, recipient-bed health, graft handling, immobilization, and recheck compliance. (cliniciansbrief.com)
The study’s design still leaves open questions. Because it was retrospective and drawn from a single private practice, treatment allocation was not randomized, and unmeasured confounders may have influenced which dogs received VAC versus standard bandaging. The next step will be prospective or multicenter comparative work that can better sort out whether certain wound locations, contamination levels, graft sizes, or patient comorbidities make VAC more useful in specific subgroups, even if the overall cohort shows no significant difference. (pubmed.ncbi.nlm.nih.gov)