Comparison of lower extremity fasciotomy wound closure techniques in children: vacuum-assisted closure device versus
Hannah Rachel Bussell1, Christoph Alexander Aufdenblatten2, Corina Gruenenfelder3
1Department of Pediatric Surgery, University Children's Hospital Zurich, Steinwiessstrasse 75, 8032, Zurich, Switzerland. hannah.bussell@kispi.uzh.ch.
Insights
Synthetic skin replacement (SSR) offers faster wound closure and shorter hospital stays for pediatric acute compartment syndrome fasciotomy wounds compared to vacuum-assisted closure (V.A.C.) devices.
Area of Science:
- Pediatric surgery
- Wound management
- Orthopedic surgery
Background:
- Optimal treatment for pediatric lower leg fasciotomy wounds remains unclear.
- Acute compartment syndrome requires timely intervention to prevent complications.
Purpose of the Study:
- To compare the efficacy of synthetic skin replacement (SSR) versus vacuum-assisted closure (V.A.C.) devices for pediatric fasciotomy wounds.
- To evaluate treatment duration and complication rates between the two methods.
Main Methods:
- Retrospective study of 27 pediatric patients with lower leg fasciotomy wounds over 10 years.
- Wounds were treated with either SSR or V.A.C. device.
- Key outcomes included procedures to closure, time to closure, hospitalization duration, and sequelae.
Main Results:
- SSR group (9 patients) showed significantly fewer procedures (1.8 vs 3.1), faster closure (4.9 vs 9.4 days), and shorter hospitalization (9.9 vs 16.2 days) compared to V.A.C. group (18 patients).
- SSR group had no recorded sequelae.
- V.A.C. group experienced one wound infection and one skin graft requirement.
Conclusions:
- Both SSR and V.A.C. devices are safe and effective for pediatric fasciotomy wound closure.
- SSR demonstrates a trend towards shorter definitive wound closure times.
Purpose:
No clear consensus on the optimal treatment of fasciotomy wounds due to acute compartment syndrome of the lower leg in children exists. We therefore compared two commonly used methods to close fasciotomy wounds, Epigard, a temporary synthetic skin replacement (SSR) and the vacuum-assisted closure (V.A.C.) device, in respect of treatment duration and complication rates.
Methods:
We studied the cases of 27 patients who were treated at our institution for acute compartment syndrome of the lower leg with a fasciotomy over a 10-year period. The fasciotomy wound was either treated with SSR or V.A.C. device. We recorded the number of procedures to definitive wound closure, days to wound closure, hospitalization days and sequelae rate.
Results:
In the V.A.C. device group (18 patients) the mean number of procedures until definitive wound closure was 3.1, mean days until wound closure was 9.4 and mean days of hospitalization was 16.2. One patient suffered from a wound infection and one patient required a full thickness skin graft. In the SSR group (9 patients), the mean number of procedures was 1.8, mean days until definitive wound closure was 4.9 and mean days of hospitalization was 9.9. No sequelae were recorded. There was a statistically significant smaller number of procedures (p value 0.018), fewer days to definitive wound closure (p value 0.002) and fewer hospitalization days (p value 0.005) in the SSR group.
Conclusions:
Both SSR and V.A.C. device are safe and reliable for closure of fasciotomy wounds in children, whereas SSR seems to lead to shorter time until definitive wound closure.
Related Concept Videos
01:28Angle Closure Glaucoma: Treatment
02:55Synthetic Biology
Golden rice
Golden rice is a genetically modified...
02:57The Sense of Self: Reflected Self-Appraisal and Social Comparison
01:22Absolute and Local Extreme Values
01:30Continuous Renal Replacement Therapy
01:28Synthetic Disvision of Polynomials