Excellent Healing of Pediatric Wounds Using Polymeric Membrane Dressings

Problem:

Treating pediatric wounds presents special challenges.  Pain relief, both during dressing changes and between them, greatly enhances compliance.  Dressings must conform well to prevent contamination, even during exuberant activity.  The toxicity of substances used in cleansing or dressing wounds is a serious concern, because young children more easily absorb chemicals through skin and immature organs are less able to cope with them.  Brisk healing is clearly a major asset.  Eleven patients, infants through preteens, all healthy other than anemia and malnutrition, treated with local herbs or no previous treatment, are depicted.  Wounds included infected abscesses, an herbal burn, a scald, a dehisced surgical wound, a laceration, an acute surgical wound and a threatened digital amputation.

Rationale:

Flexible non-toxic polymeric membrane dressings can decrease wound pain by inhibiting nociceptor activity.  Their non-adherent design usually makes dressing changes painless as well.  A built-in cleansing system allows for minimal disruption of new growth through simple, usually rinse-free dressing changes.  Glycerol soothes and hydrates dry wounds while a super-absorbent starch takes up excess wound fluid, balancing moisture.  The dressings concentrate the body’s natural healing nutrients in the wound bed, safely supporting very rapid wound healing.

Methods After initial cleansing/debriding, a polymeric membrane dressing was applied; dressings were changed when saturated.  Since the wounds usually did not need to be cleansed or rinsed again, dressing changes were so simple that often parents could perform them, even when clean water was unavailable.

Results The wounds, many of which had been chronically infected, stayed very clean.  Pain was consistently eliminated within the first day.  Dressings and changes were comfortable to the children, leading to good compliance.  The wounds all closed; time to healing was one to eight weeks.

Conclusions Polymeric membrane dressings were an elegant solution to all of the challenges presented by these pediatric patients.