Application of Cyclical Negative Pressure Wound Therapy in Paediatric Scald Burns

Year : 2024 | Volume :01 | Issue : 01 | Page : –
By

Ravi Kumar Chittoria

  1. Professor, Department of Plastic Surgery Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry India

Abstract

Managing pediatric scald burns poses a considerable challenge in promoting patient well-being and ensuring effective wound care. Negative pressure wound therapy (NPWT) is a unique method that applies negative pressure to the wound by means of a vacuum device. This technique improves wound circulation, supports granulation, and aids in exudate removal. The NPWT system, introduced by Morykwas and Argenta, has become a widely applied and influential method for healing both simple and complex wounds.The conventional NPWT system offers continuous and intermittent modes. In comparison to the continuous mode, the intermittent mode has demonstrated enhanced wound perfusion and granulation tissue formation in animal models. It alternates between -125 mmHg for five minutes and a two-minute resting phase. However, the intermittent mode’s clinical application faces challenges due to the pain experienced during the system’s initiation phase. To address this, the cyclic mode minimizes pain while maintaining the efficacy of the intermittent mode.
In a study conducted at a tertiary care hospital in South India, a one-year-old male child with scald burns on the right hand and both legs received cyclical negative pressure wound therapy (CNPWT). The treatment protocol involved fluctuating negative pressure between 0 and 125 mmHg. The child underwent two cycles of CNPWT as part of the therapeutic intervention, demonstrating its potential as an effective and less painful approach in managing pediatric scald burns. The use of CNPWT in pediatric burn care is promising, as it offers several advantages over traditional wound management techniques. By applying cyclical negative pressure, CNPWT promotes wound healing by improving blood flow, reducing edema, and removing excess exudate. Moreover, CNPWT is well-tolerated by pediatric patients and can be adjusted to accommodate their unique physiological needs. This case highlights the feasibility and potential benefits of CNPWT in treating pediatric scald burns, suggesting it as a valuable addition to the armamentarium of wound care strategies for pediatric patients.

Keywords: CNPWT, NPWT, scald burns, scalp, wound, paediatric wound therapy

[This article belongs to Recent Trends in Cosmetics(rtc)]

How to cite this article: Ravi Kumar Chittoria. Application of Cyclical Negative Pressure Wound Therapy in Paediatric Scald Burns. Recent Trends in Cosmetics. 2024; 01(01):-.
How to cite this URL: Ravi Kumar Chittoria. Application of Cyclical Negative Pressure Wound Therapy in Paediatric Scald Burns. Recent Trends in Cosmetics. 2024; 01(01):-. Available from: https://journals.stmjournals.com/rtc/article=2024/view=146343

References

1. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Annals of plastic surgery. 1997 Jun 1;38(6):563-77.
2. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Annals of plastic surgery. 1997 Jun 1;38(6):553-62.
3. Glass GE, Nanchahal J. The methodology of negative pressure wound therapy: separating fact from fiction. Journal of plastic, reconstructive & aesthetic surgery. 2012 Aug 1;65(8):989-1001.
4. Kairinos N, Voogd AM, Botha PH, Kotze T, Kahn D, Hudson DA, Solomons M. Negative-pressure wound therapy II: negative-pressure wound therapy and increased perfusion. Just an illusion?. Plastic and reconstructive surgery. 2009 Feb 1;123(2):601-12.
5. Borgquist O, Ingemansson R, Malmsjö M. Wound edge microvascular blood flow during negative-pressure wound therapy: examining the effects of pressures from–10 to–175 mmHg. Plastic and reconstructive surgery. 2010 Feb 1;125(2):502-9.
6. Kairinos N, McKune A, Solomons M, Hudson DA, Kahn D. The flaws of laser D oppler in negative‐pressure wound therapy research. Wound repair and regeneration. 2014 May;22(3):424-9.
7. Muenchow S, Horch RE, Dragu A. Effects of topical negative pressure therapy on perfusion and microcirculation of human skin. Clinical hemorheology and microcirculation. 2019 Jan 1;72(4):365-74.
8. Sogorski A, Lehnhardt M, Goertz O, Harati K, Kapalschinski N, Hirsch T, Daigeler A, Kolbenschlag J. Improvement of local microcirculation through intermittent negative pressure wound therapy (NPWT). Journal of tissue viability. 2018 Nov 1;27(4):267-73.
9. Müller‐Seubert W, Roth S, Hauck T, Arkudas A, Horch RE, Ludolph I. Novel imaging methods reveal positive impact of topical negative pressure application on tissue perfusion in an in vivo skin model. International Wound Journal. 2021 Dec;18(6):932-9.
10. Eisenhardt SU, Schmidt Y, Thiele JR, Iblher N, Penna V, Torio-Padron N, Stark GB, Bannasch H. Negative pressure wound therapy reduces the ischaemia/reperfusion-associated inflammatory response in free muscle flaps. Journal of plastic, reconstructive & aesthetic surgery. 2012 May 1;65(5):640-9.
11. Suissa D, Danino A, Nikolis A. Negative-pressure therapy versus standard wound care: a meta-analysis of randomized trials. Plastic and reconstructive surgery. 2011 Nov 1;128(5):498e-503e.
12. Lee KN, Ben‐Nakhi M, Park EJ, Hong JP. Cyclic negative pressure wound therapy: an alternative mode to intermittent system. International Wound Journal. 2015 Dec;12(6):686-92.
13. Shore AC. Capillaroscopy and the measurement of capillary pressure. British journal of clinical pharmacology. 2000 Dec;50(6):501-13.
14. Fagrell B. Dynamics of skin microcirculation in humans. Journal of Cardiovascular Pharmacology. 1985 Jan 1;7:S53-8.
15. Mahy IR, Tooke JE, Shore AC. Capillary pressure during and after incremental venous pressure elevation in man. The Journal of physiology. 1995 May 15;485(1):213-9.
16. Wong BJ, Hollowed CG. Current concepts of active vasodilation in human skin. Temperature. 2017 Mar 31;4(1):41-59.
17. Wilkin JK. Periodic cutaneous blood flow during postocclusive reactive hyperemia. American Journal of Physiology-Heart and Circulatory Physiology. 1986 May 1;250(5):H765-8.
18. Glass GE, Murphy GF, Esmaeili A, Lai LM, Nanchahal J. Systematic review of molecular mechanism of action of negative-pressure wound therapy. Journal of British Surgery. 2014 Dec;101(13):1627-36.
19. Kolbenschlag J, Sogorski A, Timmermann C, Harati K, Daigeler A, Hirsch T, Goertz O, Lehnhardt M. Ten minutes of ischemia is superior to shorter intervals for the remote ischemic conditioning of human microcirculation. Clinical Hemorheology and Microcirculation. 2017 Jan 1;66(3):239-48.
20. Sogorski A, Spindler S, Wallner C, Dadras M, Wagner JM, Behr B, Lehnhardt M, Kolbenschlag J. Optimizing remote ischemic conditioning (RIC) of cutaneous microcirculation in humans: number of cycles and duration of acute effects. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2021 Apr 1;74(4):819-27.
21. Borgquist O, Ingemansson R, Malmsjö M. Individualizing the use of negative pressure wound therapy for optimal wound healing: a focused review of the literature. Ostomy/wound management. 2011 Apr 1;57(4):44-54.
22. Jacob Antony Chakiath, Ravi Kumar Chittoria. Cyclical Negative Pressure Wound Therapy-AReview/IndianJAnat2022;11(3):87-9.


Regular Issue Subscription Original Research
Volume 01
Issue 01
Received March 12, 2024
Accepted April 5, 2024
Published May 16, 2024