Severe burns (IIb and III degree, large body surface) are from far one of the most traumatic injury in children. Not only the management of local lesions, but also the treatment of burn shock might pose a high degree of difficulty in the severe burned child. Some particular body regions like face, hand (including fingers), feet and perineum require a special care. While IIa degree burns require only conservative management of the legions and III degree burns require indubitable surgical treatment, IIb degree burns have a more complex assessment. Our work presents the importance of using NPWT (negative pressure wound treatment) in the treatment of pediatric burn patient. It helps avoiding infection, limits the severity of burn shock, reduces the edema under the burn legions (space three Randal) promotes graft taken, stimulates healing of IIb degree burns.
Material and Methods
We evaluated 9 cases. Our study includes large body surface burns (10 to 40 % BS),
IIa, IIb and III degrees. At the admission was made burn shock treatment, burn wounds cleaning followed by NPWT. For III degree burns we made surgical excision of the burned skin followed by skin grafting. Graft intake was assisted with NPWT. For IIb burns only NPWT sufficed for complete healing of the burns. Complete epitelisation was achieved in a period up to 10 days.
The evolution was favorable in all patients with complete healing of IIb degree burns, no infections, complete intake of skin grafts for III degree burns, reducing edema under burn lesions, preventing intrinsic hand muscles fibrosis in hand burns, shortening the hospitalization time.
NPWT is an excellent tool in addressing pediatric patient with severe burns. It permits complete healing of IIb degree burns, complete intake of skin graft for III degree burns, reduces the frequency of wound dressing, pain, fluid loss as well as the risk of infections. It limits the total hospitalization period and allows a much better functional and aesthetic result in the treatment of pediatric severed burned patient.