Management of "difficult" wounds
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Management of "difficult" wounds. / Neuhaus, Kathrin; Meuli, Martin; Koenigs, Ingo; Schiestl, Clemens.
In: EUR J PEDIATR SURG, Vol. 23, No. 5, 10.2013, p. 365-74.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Management of "difficult" wounds
AU - Neuhaus, Kathrin
AU - Meuli, Martin
AU - Koenigs, Ingo
AU - Schiestl, Clemens
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2013/10
Y1 - 2013/10
N2 - Pressure sores (PSs) and wounds in immunocompromised children are rather rare conditions. No doubt, their management is often complex and difficult, even for experienced pediatric plastic surgeons. As there are no algorithms for standard care, the therapeutic approach is individual.Successful PS management always implies primary and secondary prevention. With a PS present, rapid relief of pressure is crucial. If local wound care fails to restore skin integrity within a short period of time, surgical defect closure is mandatory. Overall, full-thickness skin grafts and local flap surgery are the most suitable methods regarding result quality, procedure complexity, and risks. Negative pressure wound therapy (NPWT) plays an instrumental role in wound bed preparation before definitive coverage. Recurrence rate is high (the complication). It does not much depend on the surgical technique employed, but rather depends on whether the various pathogenic factors leading to PS can be eliminated or alleviated.In both temporarily and permanently immunocompromised children, wound healing is significantly impaired. At the same time, these patients have no or low host defense activity. Thus, they are at high risk not only for local wound infection but also for potentially life threatening septic complications. Rapid and definitive wound closure is therefore essential. When conservative therapy fails, simple surgical techniques granting rapid and definitive wound closure should be used.
AB - Pressure sores (PSs) and wounds in immunocompromised children are rather rare conditions. No doubt, their management is often complex and difficult, even for experienced pediatric plastic surgeons. As there are no algorithms for standard care, the therapeutic approach is individual.Successful PS management always implies primary and secondary prevention. With a PS present, rapid relief of pressure is crucial. If local wound care fails to restore skin integrity within a short period of time, surgical defect closure is mandatory. Overall, full-thickness skin grafts and local flap surgery are the most suitable methods regarding result quality, procedure complexity, and risks. Negative pressure wound therapy (NPWT) plays an instrumental role in wound bed preparation before definitive coverage. Recurrence rate is high (the complication). It does not much depend on the surgical technique employed, but rather depends on whether the various pathogenic factors leading to PS can be eliminated or alleviated.In both temporarily and permanently immunocompromised children, wound healing is significantly impaired. At the same time, these patients have no or low host defense activity. Thus, they are at high risk not only for local wound infection but also for potentially life threatening septic complications. Rapid and definitive wound closure is therefore essential. When conservative therapy fails, simple surgical techniques granting rapid and definitive wound closure should be used.
KW - Child
KW - Humans
KW - Immunocompromised Host
KW - Negative-Pressure Wound Therapy
KW - Pressure Ulcer
KW - Reconstructive Surgical Procedures
KW - Skin Transplantation
KW - Soft Tissue Injuries
KW - Surgical Flaps
KW - Wound Healing
KW - Wound Infection
KW - Journal Article
KW - Review
U2 - 10.1055/s-0033-1354588
DO - 10.1055/s-0033-1354588
M3 - SCORING: Review article
C2 - 24008551
VL - 23
SP - 365
EP - 374
JO - EUR J PEDIATR SURG
JF - EUR J PEDIATR SURG
SN - 0939-7248
IS - 5
ER -
