Vacuum-assisted closure for wound management in the pediatric population
Andreana Bütter1, Mohammad Emran, Ayman Al-Jazaeri
1Division of Pediatric Surgery, Sainte Justine Hospital, Montreal, Quebec, Canada H3T 1C5.
Insights
Vacuum-assisted closure (VAC) is a safe and effective wound management technique for children, leading to fewer dressing changes and quicker recovery. This study highlights its benefits in pediatric wound care.
Area of Science:
- Pediatric Surgery
- Wound Healing
- Medical Devices
Background:
- Traditional wound management in children involves daily dressings.
- Vacuum-assisted closure (VAC) is established in adults but less reported in pediatric cases.
Purpose of the Study:
- To review the experience and outcomes of using vacuum-assisted closure (VAC) in a pediatric population.
- To evaluate the efficacy and safety of VAC for various pediatric wound types.
Main Methods:
- Retrospective review of 16 pediatric patients treated with VAC between 2003 and 2005.
- Analysis of patient demographics, diagnoses, VAC parameters, wound closure rates, complications, and costs.
Main Results:
- VAC therapy was used for an average of 23 days at 104 mm Hg pressure.
- Successful wound closure was achieved in 15 out of 16 pediatric patients.
- Healing times varied by diagnosis, with wound dehiscence healing in 28 days and pilonidal disease in 45-72 days.
Conclusions:
- Vacuum-assisted closure (VAC) is well-tolerated in pediatric patients.
- VAC offers advantages such as reduced dressing changes and faster return to daily activities.
- Recurrence of pilonidal sinuses was noted in all treated recurrent cases.
Background/Purpose:
Wound management in children has traditionally consisted of daily dressings. Although vacuum-assisted closure (VAC) is well described in the adult literature, there are few reports about children. We reviewed our experience with VAC.
Methods:
A retrospective review from 2003 to 2005 revealed that 16 children underwent VAC. Variables analyzed included demographics, diagnosis, duration and characteristics of VAC, wound closure, recurrence, complications, and cost analysis.
Results:
Sixteen children received VAC therapy at an average age of 12.1 years (range, 1 month-18 years). Indications included tissue loss after pilonidal sinus excision (n = 8, primary = 5, recurrent = 3) after wound dehiscence of the abdomen (3), the sternum (2), the back (1), the leg (1), and after chronic postoperative perineal fistula. Average length of VAC use was 23 days, with an average pressure of 104 mm Hg. Wound closure occurred in 15 of 16 patients. Patients with primary pilonidal disease obtained wound closure by 45 days, whereas those with recurrent disease required 72 days. Children with wound dehiscence healed by 28 days. Recurrent sinuses developed in all 3 patients with known recurrent pilonidal disease. Pain in 1 patient required cessation of VAC therapy after 7 days. Follow-up after wound closure averaged 8 months.
Conclusions:
Vacuum-assisted closure is well tolerated in our pediatric population and offers many advantages including fewer dressing changes and an earlier return to daily activities.
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