Children may develop non-healing wounds due to a wide range of pathologies – including epidermolysis bullosa (EB), pilonidal disease and Stevens-Johnson syndrome. Some causes can be iatrogenic – such as, extravasation injuries and medical device-related hospital-acquired pressure ulcers. Moreover, pediatric wounds are vastly different from adult wounds and therefore, require a different treatment approach. While there are numerous types of dressings—topical remedies and matrices—with high-tier evidence to support their use in adults, evidence is scarce in the neonatal and pediatric age groups.

A new study published in the Journal of Wound Care aimed to discuss the basic principles in pediatric wound management and to present new treatment findings published in the literature, till date.

The present review entailed a search of databases for relevant sources including Pubmed, Embase, Web of Science and DynaMed. The benefits and risks of using different types of debridement were discussed. Additionally, various topical formulations were described, including the need to use antibiotics judiciously.

The findings revealed that amniotic membrane living skin equivalent – a cellular matrix that has been reportedly successful in treating pediatric wounds and is currently under investigation in randomized clinical trials (RCTs). While Helicoll is an acellular matrix, which shows promise in children with recessive dystrophic EB. Furthermore, negative pressure wound therapy (NPWT) may be used as a tool to accelerate wound closure in children—caution must be taken due to limited evidence to support its safety and efficacy in the pediatric patient population. Integra has been reported as a useful adjunctive treatment to NPWT as they act synergistically. Because hospitalized children and neonates often develop pressure ulcers, prevention in this type of wound is of utmost importance.

In inference, it was stated that advancements in wound care are rapidly expanding. Various treatments for non-healing wounds in pediatric and neonatal patients have been reported, but high tier evidence in these populations is scarce. It was acknowledged that there have been promising results in many studies, however, RCTs involving larger sample sizes are necessary to determine the specific role these innovative agents in pediatric wound management and to identify their true safety and efficacy.

Source: Journal of Wound Care. 2020 Jun 2;29(6):321-334. doi: 10.12968/jowc.2020.29.6.321.