Negative Pressure Wound Therapy in an Infant

While there is considerable literature on negative pressure wound therapy (NPWT) in the adult population, little evidence exists on its use in the pediatric population and even less in infants.  In the case of a 55-day old infant it was decided to initiate NPWT in an attempt to reduce bowel edema, contain exudate, and accelerate healing of his open abdomen.  The patient had a history of imperforate anus and hypoplastic left heart with multiple surgeries including Stage I Norwood and a complicated course of abdominal surgeries including colostomy, ileostomy, septic abdomen, abdominal compartment syndrome, NEC, and bowel perforation.  Two days following NPWT placement edema was markedly decreased and continued to diminish.  Delayed primary closure was accomplished seven weeks after initiation of treatment; at that time the ileostomy was closed with a Derma Matrix patch and treated with NPWT.  He was discharged home at 23 weeks of age with a topical dressing and a functioning colostomy.  NPWT was used successfully in this infant with no observable adverse events, leading us to believe there is promise for use of NPWT in infants.