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The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant

  • Goh, Benjamin Kah Liang (Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital) ;
  • Chua, Alvin Wen Choong (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Chew, Khong Yik (Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital) ;
  • Kang, Gavin Chun-Wui (Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital) ;
  • Chiang, Li-Wei (Department of Paediatric Surgery, KK Women's and Children's Hospital) ;
  • Tan, Bien-Keem (Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital) ;
  • Ramachandran, Savitha (Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women's and Children's Hospital)
  • Received : 2020.05.30
  • Accepted : 2020.07.29
  • Published : 2021.05.15

Abstract

Purpura fulminans is a serious condition that can result in severe morbidity in the pediatric population. Although autologous skin grafts remain the gold standard for the coverage of partial- to full-thickness wounds, they have several limitations in pediatric patients, including the lack of planar donor sites, the risk of hemodynamic instability, and the limited graft thickness. In Singapore, an in-house skin culture laboratory has been available since 2005 for the use of cultured epithelial autografts (CEAs), especially in burn wounds. However, due to the fragility of CEAs, negative-pressure wound therapy (NPWT) dressings have been rarely used with CEAs. With several modifications, we report a successful case of NPWT applied over a CEA in an infant who sustained 30% total body surface area full-thickness wounds over the anterior abdomen, flank, and upper thigh secondary to purpura fulminans. We also describe the advantages of using NPWT dressing over a CEA, particularly in pediatric patients.

Keywords

References

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