Arch Plast Surg.  2021 May;48(3):338-343. 10.5999/aps.2020.01032.

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

• Goh BKL
• Chua AWC
• Chew KY
• Kang GCW
• Chiang LW
• Tan BK
• Ramachandran S

• KMID: 2515909
• DOI: http://doi.org/10.5999/aps.2020.01032

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.

Keyword

Negative-pressure wound therapy; Autografts; Epithelium cells; Child; Skin