Negative Pressure Wound Therapy for Split Thickness Skin Grafting to the Lower Leg After Excision of Skin Tumour: A Multicentre Randomised Study
Negative Pressure Wound Therapy for Split Thickness Skin Grafting to the Lower Leg After Excision of Skin Tumour: The Legs Trial - A Multicentre Randomised Study
Region Skane
242 participants
Nov 1, 2025
INTERVENTIONAL
Conditions
Summary
The goal of this clinical trial is to compare the effect of negative pressure wound therapy (NPWT) versus traditional dressings on the incidence of transplant infection in adult patients undergoing split-thickness skin grafting (STSG) to the lower leg following excision of a skin tumour. The main questions it aims to answer are: Does NPWT reduce the incidence of transplant infection within three months after STSG? Does NPWT improve secondary outcomes such as graft take, reduce reoperations, complications, and resource use? Researchers will compare patients treated with NPWT to patients treated with traditional dressings to see if NPWT results in lower infection rates and better clinical outcomes. Participants will: Undergo excision of a skin tumour on the lower leg followed by STSG. Be randomized to receive either NPWT or traditional dressings applied over the graft. Follow a structured postoperative care and mobilisation schedule. Attend follow-up visits at day 5 and day 14 postoperatively and be monitored through medical record review up to three months after surgery.
Eligibility
Inclusion Criteria5
- Adults aged 18 years or older
- Undergoing excision of a skin tumour on the lower leg with planned coverage using split-thickness skin grafting (STSG)
- Eligible procedures include primary excision, secondary excision, or extended excision performed at the same site as a previous tumour surgery
- Ability to provide written informed consent
- Ability to comply with postoperative instructions and follow-up visits
Exclusion Criteria17
- Inability to follow postoperative instructions due to cognitive impairment, dementia, or significant language barriers
- Inability to provide informed consent
- Severe systemic illness, including:
- Ongoing sepsis
- Advanced heart failure
- End-stage renal or liver disease
- Active chemotherapy within the previous three months
- Ongoing treatment with immunosuppressive medications, including:
- Systemic corticosteroids (e.g., prednisone >20 mg/day or equivalent)
- Calcineurin inhibitors (e.g., cyclosporine, tacrolimus)
- Antimetabolites (e.g., methotrexate, azathioprine, mycophenolate mofetil)
- mTOR inhibitors (e.g., sirolimus, everolimus)
- Biologic therapies (e.g., rituximab, TNF inhibitors, IL-6 inhibitors, IL-1, IL-17, IL-23 inhibitors)
- Targeted molecular therapies (e.g., JAK inhibitors such as tofacitinib, baricitinib)
- Other immunosuppressive drugs
- Previous radiation therapy to the surgical site
- Presence of severe skin disease affecting the planned graft recipient site (e.g., advanced psoriasis)
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Interventions
Negative pressure wound therapy (NPWT) applied over the split-thickness skin graft on the lower leg after tumour excision. A protective silicone interface layer will be used, with continuous negative pressure of -125 mmHg applied until postoperative day 5, unless earlier change is clinically indicated.
Traditional dressing applied over the split-thickness skin graft on the lower leg after tumour excision. The dressing consists of one or more layers of foam dressing applied on top, which may or may not be fixed with sutures according to surgeon preference, and an elastic bandage applied over the foam to provide gentle, even compression and immobilisation of the graft. The dressing will remain undisturbed until postoperative day 5 unless earlier change is clinically indicated.
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT07040683