Vacuum-Assisted Wound Closure Therapy in Pediatric Lower Limb Trauma.

Abstract

Although the importance of vacuum-assisted wound closure therapy has been well established as road to definitive treatment of trauma wound in the adult population, its use in pediatric patients is not well described in the literature. This study was conducted to evaluate the outcome of vacuum-assisted wound closure therapy in pediatric patients. Twenty-two patients were prospectively treated for soft tissue defect in lower limb using vacuum-assisted wound closure device, as these wounds were not amenable for primary closure. After wound evaluation, thorough wound debridement was done. Vacuum-assisted wound closure dressing was applied once hemostasis was achieved. Dressings were changed as per protocol. After the development of healthy granulation tissue, wound coverage was achieved with skin graft or flaps. Mean age of patients was 9.455 years, ranging from 4 to 14 years. Early, healthy granulation tissue had formed in all patients. The average number of vacuum-assisted closure (VAC) dressings required was 2.682. Average duration of VAC therapy was 8.045 days. The sizes of soft tissue defects reduced from an average 69.18 cm2 to 50.73 cm2 after VAC therapy with a mean decrease of 26.66%. There was no complication because of VAC therapy. Vacuum-assisted wound closure therapy accelerated the process of healthy granulation tissue formation, and thus shortened the healing time. VAC therapy lessens the morbidity and pain associated with large wounds in pediatric patients and brings cheer and smile in growing children.