Treatment of Soft Tissue Defects in Pediatric Patients Using the V.A.C.??? System

Mooney, James F.; Argenta, Louis C.; Marks, Malcolm W.; Morykwas, Michael J.; DeFranzo, Anthony J.

doi:10.1097/00003086-200007000-00005

Cited by 118 publications

(87 citation statements)

References 6 publications

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“…Several retrospective case series provide evidence that use of NPWT in neonates and children can augment wound healing in a variety of acute and chronic wounds, including infected wounds, those with exposed orthopedic hardware, and surgical wound dehiscence, with successful use reported in 92-100% of patients. 19,[59][60][61][62][63] Reported complications, including enteric fistula formation, bleeding, pain, and periwound skin breakdown, were uncommon and in the case of fistula formation, related at least in part to the patients' underlying disease process. In addition to facilitating wound healing, benefits of NPWT included decreased frequency of dressing changes, reduced need for use of pain medication, and decreased length of hospital stay.…”

Section: 58mentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moistureassociated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. SCOPE AND SIGNIFICANCEGiven the lack of consensus on the optimal strategies for common wound care management issues in the neonatal and pediatric populations and the large number of wound care products on the market today, it can be challenging to make informed decisions regarding wound care in these populations. A comprehensive review of the literature on the following specific areas of focus: pressure ulcers, surgical wounds, epidermal stripping, intravenous extravasation injuries, moisture-associated skin damage (MASD), and use of negative-pressure wound therapy (NPWT) is presented, along with management recommendations based on the clinical experience of the authors.

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Section: 58mentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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“…TM , Kinetic Concepts, Inc., San Antonio, TX, USA) is a new efficient system for wound conditioning in treatment of problematic wounds [19,22,25,36,47,48,52]. Until now, this technique was applied in spinal surgery in one case report and one retrospective study only [44,70].…”

Section: Introductionmentioning

confidence: 99%

Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

et al. 2006

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The use of vacuum assisted closure (V.A.C.) therapy in postoperative infections after dorsal spinal surgery was studied retrospectively. Successful treatment was defined as a stable healed wound that showed no signs of acute or chronic infection. The treatment of the infected back wounds consisted of repeated debridement, irrigation and open wound treatment with temporary closure by V.A.C. The instrumentation was exchanged or removed if necessary. Fifteen patients with deep subfascial infections after posterior spinal surgery were treated. The implants were exchanged in seven cases, removed completely in five cases and left without changing in one case. In two cases spinal surgery consisted of laminectomy without instrumentation. In two cases only the wound defects were closed by muscle flap, the remaining ones were closed by delayed suturing. Antibiotic treatment was necessary in all cases. Follow up was possible in 14 patients. One patient showed a new infection after treatment. The study illustrates the usefulness of V.A.C. therapy as a new alternative management for wound conditioning of complex back wounds after deep subfascial infection.

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“…We did not find any studies reporting NPWT monitoring and maintenance of the machine. However, as with any medical device, it is good practice that the equipment is fully functioning and safety checks are undertaken regularly 50 .…”

Section: Discussionmentioning

confidence: 99%

“…Mooney et al 50 noted that some paediatric patients experienced a higher rate of tissue granulation which may have caused in-growth into the polyurethane foam. The use of polyvinyl alcohol foam or a non-adhesive barrier to prevent such granulation is recommended by NPWT manufacturers.…”

Section: Discussionmentioning

confidence: 99%