[Role of the association artificial dermis and negative pressure therapy: about two cases]

In our modern health system, the improvement of the medical care cannot come along with an increase of expenses. In this purpose, we tried to bring to light the medical and economic, direct and indirect, benefits which exist with the association of an artificial dermis, Integra, and negative pressure therapy as the vacuum assisted closure (VAC) for wound which would have been treated by Integra alone. While preserving the aesthetic and functional qualities obtained by the artificial dermis alone followed by a skin graft after 21 days of treatment, the association of the negative pressure allows to perform the skin graft after only 10 days of treatment. This gain of time is a financial economy for the medical centers which have to shorten the durations of stay to be profitable. The patient benefits of a shorter hospitalization and will manage to return to work earlier. The quality of the treatment is not only improved by the absentia of immobilization of the patient but also by the decrease of the complications and the infectious risks due to the use of artificial dermis. The results so obtained highlight that in spite of the initial expense caused by this association the advantages are such that the use of the artificial dermis alone will not have interest any more.