Vacuum-assisted closure for complicated neonatal abdominal wounds
Gregory Lopez1, Robin Clifton-Koeppel, Sherif Emil
1Division of Pediatric Surgery, University Children's Hospital, University of California Irvine School of Medicine, Orange, CA 92868, USA.
Journal of Pediatric Surgery
|December 2, 2008
Summary
Vacuum-assisted closure (VAC) is safe and effective for complex neonatal abdominal wounds, including those with stomas or fistulae. This method promotes complete wound healing in infants of all gestational ages and birth weights.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Wound care
Background:
- Limited data exists on neonatal use of vacuum-assisted closure (VAC) for complex abdominal wounds.
- Neonatal abdominal wound complications present unique management challenges.
Purpose of the Study:
- To evaluate the safety and efficacy of vacuum-assisted closure (VAC) for complex abdominal wounds in neonates.
- To assess outcomes of neonatal VAC therapy in a diverse patient population.
Main Methods:
- Retrospective review of medical records for neonates treated with a standardized VAC protocol from 2004-2007.
- Analysis of patient demographics, wound characteristics, VAC application details, and patient outcomes.
- Continuous data reported as mean +/- SD (range).
Main Results:
- Ten VAC applications were performed in 8 neonates with complex abdominal wounds, often post-laparotomy.
- Wounds included intestinal stomas and enterocutaneous fistulae; average wound area was 13.6 cm².
- VAC therapy resulted in complete wound closure in all cases without local or systemic complications; 63% of patients survived.
Conclusions:
- Vacuum-assisted closure (VAC) is a safe and successful treatment for complex neonatal abdominal wounds, regardless of gestational age or birth weight.
- VAC therapy is effective even in the presence of challenging wound complications such as stomas and enterocutaneous fistulae.
- This approach offers a viable wound management strategy for critically ill neonates.
