INTEGRATED APPROACH TO THE TREATMENT OF CHILDREN WITH

LONG-TERM WOUNDS Russian State Medical University Named by N.I. Pirogov,

Children Surgery Unit Moscow Children Hospital Named by G.N.Speransky

Moscow Russia

Successful diagnosis and treatment of children early age (from 1 month to 1.5 years old) with long-term injuries is not possible without a multidisciplinary approach to the management.

Aim: Determine the efficacy of single use PICO in

treating children with chronic nonhealing wounds of various etiologies.

Contact burn III degree of both low extremities S=8% TBSA. (A boy 4 months old)

Wounds on the 4th day after injury. Surgery: Fascial excision S=8% TBSA

Wounds on the 11th day after injury. Surgery: Hydrosurgery. Grafting by split grafts meshed 1:4 S=8% TBSA

Wounds on the 24th day after injury. Surgery: Hydrosurgery escharectomy S=2% TBSA. Beginning of NPWT 80 mm Hg

Wound on the 10th day of NPWT (80 mm Hg)

Hydrosurgery. Grafting by full-thickness graft S=2% TBSA (34 day after burn trauma)

Restoration of skin integrity on 46th day after burn NPWT (80 mm Hg) 4 days after

grafting

Iatrogenic necrosis of soft tissues S=2% TBSA. Subcutaneus calcinate. (A girl 1 month old)

A wound before treatment

Escharectomy 2% TBSA

Board of subcutaneus calcinate

The 10th day after grafting 4 months after surgery

12 days of NPWT (80 mm Hg) Steps of using NPWT

Conclusions: Single use negative pressure wound therapy system PICO application in practice of treating young children with a variety of wounds reduced the time of restoring the integrity of the skin, provides patient comfort, improves postoperative functional and cosmetic results.