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Using Negative Pressure Therapy for Wound Healing in the Extremely Low-Birth-Weight Infant (Micropreemie)
1Barbara McGarrah, BSN, RN, CWON, WOC Nurse, Texas Health Harris Methodist Ft Worth, 1300 W Terrell, Ft Worth.
Insights
Negative pressure wound therapy (NPWT) is feasible for micropreemies with surgical complications. This approach effectively aids wound closure and reduces dressing changes in extremely premature infants.
Area of Science:
- Neonatal Surgery
- Pediatric Wound Care
Background:
- Micropreemies (infants < 800g or < 26 weeks gestation) have fragile gastrointestinal tracts.
- Necrotizing enterocolitis (NEC) is a common surgical complication in premature infants.
- Surgical intervention for NEC requires specialized wound care strategies.
Observation:
- A case study involving a micropreemie born at 23 weeks 5 days gestation, weighing 530g.
- The infant developed suspected intestinal perforation requiring exploratory laparotomy, ileal resection, and stoma formation.
- Abdominal closure utilized a porcine small intestine submucosa patch, followed by negative pressure wound therapy (NPWT).
Findings:
- Negative pressure wound therapy (NPWT) with open cell reticulated black foam was successfully applied.
- NPWT facilitated wound healing and closure in this micropreemie.
- The use of NPWT decreased the frequency of dressing changes compared to conventional methods.
Implications:
- This case demonstrates the feasibility and effectiveness of NPWT in selected micropreemie infants.
- NPWT offers a potential advancement in managing surgical wounds in extremely premature neonates.
- Further research into NPWT applications in neonatal surgical wound care is warranted.
Background:
The term micropreemie describes an infant born weighing less than 1 pound 12 ounces (800 g) or before 26 weeks' gestation. The gastrointestinal tract of these premature infants is fragile due to developmental immaturity. In this case study, we describe our experience with wound care following surgical intervention for necrotizing enterocolitis in a micropreemie.
Case:
Baby A is a female who was born at 23 weeks 5 days; she weighed 530 g. On day 12 of life, a sonogram was interpreted as suspicious for intestinal perforation. She underwent exploratory laparotomy with ileal perforation resection and stoma formation. A patch made from porcine small intestine submucosa was used to close the abdomen and negative pressure therapy using an open cell reticulated black foam was placed to assist with wound healing and decrease the need for frequent dressing changes.
Conclusion:
Our experience with this case demonstrates the feasibility of negative pressure wound therapy in selected micropreemie infants. Negative pressure therapy was effective in wound closure and decreased the number of dressing changes anticipated using conventional wound care.
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