Statement of Clinical Problem:
Children with a variety of underlying medical and surgical conditions are at risk for developing complex wounds. This case series describes 5 pediatric surgical patients with wounds: 3 with pilonidal abscesses, 1 with an abdominal wound dehiscence and 1 with an abscess and osteomyelitis. Of these patients, 3 were female and 2 were male. The age range was 12-18 years. There was 1 patient with Crohn’s disease.
Description of Past Management:
Pilonidal wounds commonly have a prolonged healing time. Current non-surgical treatments have not shown superior outcomes. These costly management strategies include dressings (e.g. hydrofiber, hydrogel or calcium alginate with/without silver) and negative pressure wound therapy. Since these treatment strategies are very expensive with extended closure times, medical grade honey (MGH) was trialed as a less costly option and in an attempt to decrease healing time. Given the satisfactory outcomes of the first few trials, MGH was then trialed on a wound dehiscence and abscess with osteomyelitis.
Current Clinical Approach:
Of the many forms of MGH available for use, calcium alginate and gel were utilized. All wounds were cleansed using normal saline prior to application of MGH and covered with a secondary dressing. All dressings were changed every 24-48 hours.
Overall, 4 patients (80%) showed complete epithelialization of the wound 3 weeks after starting MGH dressings. There were no negative side effects (e.g. pain, allergy). Parents and patients reported ease of use and decreased wound odor.
This study shows the effectiveness of wound management in the pediatric patient as evidenced by the reduction in wound size and subsequent epithelialization of the wounds. MGH is a cost effective and efficacious option and should be considered when treating pediatric surgical wounds.