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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.
Patient Outcomes:
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.
Conclusions:
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.