Enhanced tracheostomy wound healing using maltodextrin and silver alginate compounds in pediatrics: a pilot study
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Published on: September 8, 2023
Larry D Hartzell1, Tara N Havens2, Brian H Odom3
1Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital.
Insights
Maltodextrin gel and silver alginate sponge effectively treat pediatric tracheostomy wounds, leading to complete healing in an average of 12.8 days with no adverse effects. This novel treatment offers a safe and efficient option for managing these common pediatric complications.
Area of Science:
- Pediatric Surgery
- Wound Healing
- Dermatology
Background:
- Tracheostomy wounds in children are common but underreported, often resulting in prolonged and unpredictable healing times.
- Limited treatment options exist for pediatric tracheostomy-related wounds.
- Maltodextrin gel (MD) and silver alginate sponge (AG) have shown promise in expediting wound healing.
Purpose of the Study:
- To evaluate the efficacy and safety of maltodextrin gel (MD) and silver alginate sponge (AG) in treating pediatric tracheostomy-related wounds.
- To assess healing times and outcomes for children with stage 2 or greater tracheostomy ulcers treated with MD and/or AG.
Main Methods:
- Retrospective review of 11 pediatric patients with tracheostomy wound complications at a tertiary care facility over 11 months.
- Wound evaluation using the National Pressure Ulcer Advisory Panel staging system.
- Inclusion criteria: stage 2 or greater tracheostomy-related ulcers treated with MD and/or AG; exclusion: outpatient-treated wounds.
Main Results:
- Eleven pediatric patients with tracheostomy-related wounds (stages 2-4) were treated with MD and/or AG.
- All wounds achieved complete epithelialization within an average treatment duration of 12.8 days (range 6-28 days).
- No adverse effects were reported during treatment with MD and/or AG.
Conclusions:
- Maltodextrin gel and silver alginate sponge are effective and safe treatments for pediatric tracheostomy-related ulcers.
- These novel treatments can significantly expedite the healing process for complex pediatric wounds.
Background:
Tracheostomy wounds are commonly encountered in children but rarely reported. Relatively few treatments are available or have been investigated to manage this problem. Healing times for pediatric tracheostomy wounds are often unpredictable and protracted. Recent use of maltodextrin gel (MD) and a silver alginate sponge (AG) at our institution has demonstrated expedited healing and interest in this novel treatment for tracheostomy wounds.
Methods:
We conducted an 11-month retrospective review of children with wound complications following tracheostomy placement at a tertiary care facility. Wounds were evaluated and rated based upon the National Pressure Ulcer Advisory Panel staging system. Subjects identified with stage 2 or greater tracheostomy-related ulcers treated with MD and/or AG were included. Subject characteristics and wound healing rates were tabulated in a database that included age, wound site, initial and final wound stage, type of treatment, length of treatment, and complications. Tracheostomy wounds treated as an out-patient were excluded from the study.
Results:
Eighteen subjects, which included both in-patients and out-patients, were treated with AG and/or MD during the study period for tracheostomy-related wounds. Of the 26 subjects with tracheostomies performed during the study period, 10 (38.5%) were treated for postoperative wounds. A total of 11 subjects completed their in-patient wound treatment and were thus included in the study. Average subject age was 5.3 y (range 0.25-15.6 y). Wound locations were as follows: infrastomal region (n = 8), stoma (n = 2), and lateral neck (n = 1). Six subjects had stage 2 wounds, 4 had stage 3 wounds, and 1 had a stage 4 ulcer. All wounds achieved complete epithelialization following treatment with MD and/or AG. The average length of treatment was 12.8 d (range 6-28 d). No adverse effects were identified.
Conclusions:
Postoperative tracheostomy wounds are common. The use of MD and AG provides an effective and safe treatment for tracheostomy-related ulcers.
