Negative pressure wound therapy in infants and children: a single-institution experience

J Surg Res. 2013 Sep;184(1):658-64. doi: 10.1016/j.jss.2013.05.056. Epub 2013 Jun 4.

Abstract

Background: Information regarding the use of negative pressure wound therapy (NPWT) in the pediatric population is limited. Because of adverse outcomes in adult patients, the Food and Drug Administration issued a warning in 2011 about the use of NPWT in infants and children.

Methods: We performed an institutional review board-approved, single-institution, retrospective review of pediatric patients who had undergone NPWT from 2007-2011. We collected the types of wounds for which NPWT was initiated, the NPWT outcomes, and the complications encountered.

Results: The data from 290 consecutive patients were reviewed. Their average age was 9.3 y (range 12 d to 18 y), and their average weight was 46.5 kg (range 1.1-177). Of the wounds, 66% were classified as acute, 10% as chronic, and 24% as traumatic. The two most common indications were surgical wound dehiscence (n = 47) and skin grafting (n = 41). NPWT was used in 15 wounds containing surgical hardware, with 2 devices requiring eventual removal. NPWT was used for a median of 9 d per patient (two dressing changes). Complications occurred in 5 patients (1.7%). Documentation problems were noted in 44 patients. After NPWT, about one-third of the patients (n = 95 patients) were able to undergo delayed primary closure.

Conclusions: NPWT is an effective adjunct in wound healing and closure in the pediatric population, with no mortality ascribed to NPWT. Also, the complication rates were low.

Keywords: Abdominal wounds; Infants; Negative pressure wound therapy; Neonatal; Surgery; Wound healing.

MeSH terms

  • Abdominal Wound Closure Techniques
  • Adolescent
  • Bone Neoplasms / epidemiology
  • Bone Neoplasms / surgery
  • Child
  • Child, Preschool
  • Comorbidity
  • Enteral Nutrition
  • Female
  • Hidradenitis Suppurativa / epidemiology
  • Hidradenitis Suppurativa / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Negative-Pressure Wound Therapy / methods*
  • Osteosarcoma / epidemiology
  • Osteosarcoma / surgery
  • Parenteral Nutrition
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / epidemiology
  • Retrospective Studies
  • Skin Transplantation / methods*
  • Surgical Wound Dehiscence / diet therapy
  • Surgical Wound Dehiscence / epidemiology
  • Surgical Wound Dehiscence / therapy*
  • Surgical Wound Infection / diet therapy
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / therapy*
  • Wound Healing
  • Wounds and Injuries / diet therapy
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / therapy*