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Negative pressure wound therapy in infants and children: a single-institution experience
Rebecca M Rentea1, Kimberly K Somers, Laura Cassidy
1Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Insights
Negative pressure wound therapy (NPWT) is effective for pediatric wound healing and closure, demonstrating low complication rates in a retrospective review. This therapy aids in delayed primary closure for many young patients.
Area of Science:
- Pediatric Surgery
- Wound Management
- Medical Devices
Background:
- Limited data exists on Negative Pressure Wound Therapy (NPWT) use in pediatric patients.
- FDA issued a 2011 warning due to adverse outcomes in adult NPWT cases.
- Pediatric NPWT information is scarce, necessitating further investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of NPWT in pediatric wound healing.
- To identify common indications and outcomes of NPWT in children.
- To assess complication rates associated with NPWT in the pediatric population.
Main Methods:
- Retrospective review of 290 pediatric patients treated with NPWT from 2007-2011.
- Data collected included wound types, NPWT outcomes, and complications.
- Institutional review board approval was obtained for this single-institution study.
Main Results:
- NPWT was used for acute (66%), chronic (10%), and traumatic (24%) wounds, with surgical dehiscence and skin grafting being common indications.
- The therapy was applied for a median of 9 days, with a low complication rate of 1.7% (5 patients).
- Approximately one-third of patients (n=95) achieved delayed primary closure after NPWT.
Conclusions:
- Negative Pressure Wound Therapy (NPWT) is a safe and effective adjunctive treatment for pediatric wound healing.
- The study found no mortality associated with NPWT in the pediatric cohort.
- Low complication rates suggest NPWT is a viable option for wound management in children.
Background:
Information regarding the use of negative pressure wound therapy (NPWT) in the pediatric population is limited. Because of adverse outcomes in adult patients, the Food and Drug Administration issued a warning in 2011 about the use of NPWT in infants and children.
Methods:
We performed an institutional review board-approved, single-institution, retrospective review of pediatric patients who had undergone NPWT from 2007-2011. We collected the types of wounds for which NPWT was initiated, the NPWT outcomes, and the complications encountered.
Results:
The data from 290 consecutive patients were reviewed. Their average age was 9.3 y (range 12 d to 18 y), and their average weight was 46.5 kg (range 1.1-177). Of the wounds, 66% were classified as acute, 10% as chronic, and 24% as traumatic. The two most common indications were surgical wound dehiscence (n = 47) and skin grafting (n = 41). NPWT was used in 15 wounds containing surgical hardware, with 2 devices requiring eventual removal. NPWT was used for a median of 9 d per patient (two dressing changes). Complications occurred in 5 patients (1.7%). Documentation problems were noted in 44 patients. After NPWT, about one-third of the patients (n = 95 patients) were able to undergo delayed primary closure.
Conclusions:
NPWT is an effective adjunct in wound healing and closure in the pediatric population, with no mortality ascribed to NPWT. Also, the complication rates were low.
