Vacuum-assisted closure for wound management in the pediatric population

Bütter, Andreana; Emran, Mohammad A.; Al‐Jazaeri, Ayman; Ouimet, Alain

doi:10.1016/j.jpedsurg.2006.01.061

Cited by 62 publications

(46 citation statements)

References 7 publications

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“…[7][8][9][10]12 Interestingly enough, in 2005 there were 3 random prospective studies from general surgeons that showed the following.…”

Section: Discussionmentioning

confidence: 99%

“…There is no mention of it in the indexes of recent textbooks on pediatric surgery, 2-4 and only 7 papers have appeared on this topic in the pediatric surgery literature since 1972 (all since 1990). [5][6][7][8][9][10][11] Moreover, the Journal of Pediatric Surgery has only 3 references to pediatric pilonidal disease in its indexes from 2000 to 2008, inclusive. [9][10][11] One must therefore surmise that this problem almost always occurs in adolescents, that its treatment is virtually the same as for adults and that many of these patients are treated by general surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11] Moreover, the Journal of Pediatric Surgery has only 3 references to pediatric pilonidal disease in its indexes from 2000 to 2008, inclusive. [9][10][11] One must therefore surmise that this problem almost always occurs in adolescents, that its treatment is virtually the same as for adults and that many of these patients are treated by general surgeons. [7][8][9][10]12 Interestingly enough, in 2005 there were 3 random prospective studies from general surgeons that showed the following.…”

Section: Discussionmentioning

confidence: 99%

“…We considered all postoperative infections as recurrences, because we observed that these infections never healed until treated as a recurrence. 17 Other authors reported an equally high recurrence rate, causing a search for alternative methods of closure (vacuum-assisted primary closure, 9,10 primary closure with suction drainage, 7,12 Karydakis asymmetric skin flap 8,12,18 and the Bascom cleft lift midline shift closure 19 ), which lowered their recurrence rates to 14%, 12%, 4% and 0%, respectively. The latter 2 proced ures seem to offer the best results but have not been universally embraced by pediatric surgeons.…”

Section: Discussionmentioning

confidence: 99%

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A pediatric surgeon's 35-year experience with pilonidal disease in a Canadian children's hospital

Nasr

Ein²

2011

Can J Surg

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Background:There is an ongoing debate regarding the optimal surgical management for pilonidal disease in the pediatric population. The purpose of this study was to evaluate a pediatric surgeon's experience at a Canadian children's hospital over 35 years. Methods:We performed a retrospective review of the charts of patients seen and treated from July 1969 to December 2003, inclusive. All patients were evaluated for age, sex, clinical diagnosis, infection, treatment, healing time, complications and results.Results: In all, 121 adolescents with pilonidal disease (64 boys, 57 girls) with a mean age of 15 (range 12-19) years were evaluated at the same children's hospital. The 107 (88%) patients with infection (46% acute) underwent surgery. At operation, all 107 pilonidal cysts were either excised and packed open, marsupialized or excised and closed primarily without drainage under general anesthesia; the operation performed was arbitrarily chosen. Vacuum-assisted closure was not used. All patients received antibiotics. The time for healing after the initial operation in the group whose cysts were excised and packed open was at least twice as long (75 d) as in the other 2 groups (p = 0.031). Disease recurred in 24 (22%) patients, 6 (25%) of whom experienced 2 recurrences. Among the 90 patients in the excised and packed open group, 20 (22%) experienced recurrences and 5 (25%) experienced 2 recurrences. Among the 13 patients in the marsupialized group, 3 (23%) experienced recurrences and 1 (33%) experi enced 2 recurrences. Among the 4 patients in the excised and closed primarily without drainage group, 1 (25%) experienced a recurrence and none experienced 2 recurrences (p = 0.12). Each recurrence was smaller than the original. All wounds eventually healed. There were no other complications and no deaths. A multivariable logistic regression analysis revealed that the type of surgical approach was not predictive of recurrence after controlling for age and sex. Conclusion:Age, sex and surgical approach were not predictive of recurrence. From our experience, excision and packing open the wound produced a longer morbidity but offered the same results compared with marsupialization or excision and primary closure without drainage.Contexte : Le débat se poursuit au sujet de la prise en charge chirurgicale optimale de la maladie pilonidale dans la population pédiatrique. Cette étude visait à évaluer l'expérience qu'un chirurgien pédiatrique a acquise en 35 ans dans un hôpital canadien pour enfants. Méthodes :Nous avons procédé à une étude rétrospective des dossiers de patients vus et traités de juillet 1969 à décembre 2003 inclusivement. Nous avons évalué tous les patients selon l'âge, le sexe, le diagnostic clinique, l'infection, le traitement, la durée de la guérison, les complications et les résultats.Résultats : Au total, 121 adolescents qui avaient une maladie pilonidale (64 garçons, 57 filles) et qui étaient âgés en moyenne de 15 (de 12 à 19) ans ont été évalués au même hôpital pour enfants. Les 107 (88 %) patients qui av...

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“…[7][8][9][10]12 Interestingly enough, in 2005 there were 3 random prospective studies from general surgeons that showed the following.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

A pediatric surgeon's 35-year experience with pilonidal disease in a Canadian children's hospital

Nasr

Ein²

2011

Can J Surg

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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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Risk Factors of Pilonidal Sinüs in Teenagers

Yıldız

İlçe

2017

Biofilm, Pilonidal Cysts and Sinuses

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Vacuum-assisted closure for wound management in the pediatric population

Cited by 62 publications

References 7 publications

A pediatric surgeon's 35-year experience with pilonidal disease in a Canadian children's hospital

A pediatric surgeon's 35-year experience with pilonidal disease in a Canadian children's hospital

Dressings and Products in Pediatric Wound Care

Risk Factors of Pilonidal Sinüs in Teenagers

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