STATEMENT OF CLINICAL PROBLEM: Negative pressure wound therapy devices (NPWT) are being used more frequently in children of various ages. Three pediatric case studies are presented where a NPWT device was implemented. The female infant had an ulcerating hemangioma surgically removed. The female toddler was critically ill and required abdominal fasciotomies for compartment syndrome. The adolescent had surgery to correct a pectus excavatum and developed an infection in the sternal wound.

DESCRIPTION OF PAST MANAGEMENT: The infant's wound was treated immediately post-operatively with a NPWT device. The toddler was initially treated with wet to dry dressings TID and then the wound was covered with a transparent film dressing and connected to wall suction. The adolescent was initially treated with wet to dry dressings BID that were very painful and anxiety producing for him.

CURRENT CLINICAL APPROACH: A NPWT was placed for each child with specific interventions taken to protect their periwound skin, decrease pain, and maximize wound healing.

PATIENT OUTCOMES: Results of the negative pressure therapy were very positive. The infant's hemangioma healed within six weeks without the need for additional surgery. The toddler had the NPWT in place for three weeks and it was successful in managing the wound exudate, relieving the edema, contracting the wound and promoting granulation. The adolescent utilized the negative pressure therapy for three weeks until granulation tissue filled in the wound.

CONCLUSION: Negative pressure therapy has been used more frequently in adults but these studies demonstrate its efficacy with several different types of wounds and age groups of children. The WOC nurse should include this therapy in her treatment differential as a valuable option for her pediatric patients.

FINANCIAL ASSISTANCE/DISCLOSURE: No financial assistance was received for this study.