Use of vacuum-assisted closure system in the management of complex wounds in the neonate

Abstract

The vacuum-assisted closure (VAC) system has become an accepted treatment modality for acute and chronic wounds in adults. The use of negative-pressure dressing has been documented in adults and, to some extent, in children. However, its use in premature infants has not been reported in the literature. The results of using the VAC system were examined in two premature infants with complex wounds. The VAC system was found to be effective in facilitating the closure of large and complex wounds in these patients. Complete epithelialization of the wounds was achieved in both patients without skin grafting. In conclusion, in two premature neonates with extraordinary soft tissue defects, the VAC system was a safe and effective choice to assist in closing these wounds.

Negative pressure wound therapy: eleven-year experience at a tertiary care hospital

“…12 The use of VAC has been carried out in all age groups including premature neonates with extraordinary soft tissue defects to assist in closing wounds. 17 The youngest patient in present study was a three year old child with post road traffic accident foot defect whereas the oldest was 86 years old with diabetic foot wound. Most of our patients were in 3 rd or 4 th decade and had wounds mostly due to trauma.…”

Vacuum-assisted closure for complicated neonatal abdominal wounds

“…Vacuum-assisted closure, a method that applies negative pressure to wound beds, has been credited with shortening the time necessary for wound closure as compared to conventional methods and has become a widely accepted treatment modality in the care of complex wounds [1][2][3][4][5][6][7][8][9][10][11][12][13]. The VAC therapy has been reported in several series in adults and children, but the experience is still relatively limited in the neonatal and low-birth-weight populations.…”

“…Some modifications from previously published adult and child VAC protocols were necessary, especially for patients weighing less than 1500 g at time of VAC application. In the literature, negative pressures of 125 mm Hg for adults, 75 mm Hg for adolescents and older children, and 50 mm Hg for newborns have been described [5,6,10,12]. There are limited reports of negative pressure wound therapy in extremely low-birth-weight infants, and concerns about applying 50 mm Hg to the wound of an infant weighing less than 1500 g at VAC application are multiple, including hemodynamic changes, pain, and wound disruption.…”

“…For the past decade, vacuum-assisted closure (VAC) has become an accepted treatment modality for children and adults with complex wounds and abdominal wall defects [1][2][3][4][5][6][7][8][9][10][11]. However, the neonatal VAC therapy experience remains scant and limited mainly to case reports [2,6,12] or small case series included in larger pediatric experiences [1,5,7]. This study reports our experience with 8 neonatal patients, and the highly successful use of VAC therapy in the care of their complicated abdominal wounds.…”

Uso de terapia de vacío en el Hospital Infantil La Fe de Valencia (España): experiencia y resultados

“…Los estudios son todos retrospectivos o de presentación de casos y con un tamaño de muestra limitado; pero en todos ellos la terapia ha sido efectiva en distintos tipos de heridas y ha permitido un cierre directo de las mismas sin necesidad de intervención quirúrgica (1,(4)(5)(6)(7)(9)(10)(11)15). En general, todos los autores coinciden en la necesidad de controlar la pérdida de fluidos en este tipo de pacientes, así como en usar presiones más bajas.…”