Hypothesis: Use of the vacuum assisted closure device (VAC) for securing split-thickness skin grafts (STSGs) is associated with improved wound outcomes compared with bolster dressings. Design: Consecutive case series. Patients and Setting: Consecutive patients at a level I trauma center requiring STSG due to traumatic or thermal tissue loss during an 18-month period. Main Outcome Measure: Repeated skin grafting due to failure of the initial graft. Secondary outcome measures included dressing-associated complications, percentage of graft take, and length of hospital stay. Results: Sixty-one patients underwent STSG placement. Indications for STSG were burn injury (n=32), soft tissue loss (n=27), and fasciotomy-site coverage (n=2). Patients were treated with the VAC (n = 34