Use of Active Leptospermum honey (ALH) and Dehydrated Amniotic Membrane Allograft (DAMA) to manage extravasation wounds in neonates

Objectives:

To demonstrate the effectiveness of ALH to safely aid in autolytic debridement and wound bed preparation followed by DAMA application to facilitate the healing progress of extravasation wounds in the neonatal population.

Methods:

ALH has been used in wound care since antiquity and amniotic tissue was first noted to be used in burn care in the early 1900’s at John’s Hopkins Hospital. Wounds acquired in the hospital, such as IV associated wounds, are of particular concern to parents and caregivers.  First prevention, then expedited healing, scar minimization, and earliest possible discharge to home are the optimal goals. We have 4 cases to present with this duel treatment of ALH to prepare the wound bed, and DAMA to promote rapid healing with minimal scarring.

Case 1: 32 week neonate - IV extravasation wound to R hand 1.5 x 1.4 x UTD (undetermined depth) due to slough. Use of ALH and DAMA resulted in complete closure in 27 days.

 

Case 2: 24 week gestation, 12 weeks old – R foot extravasation 3.5 x 2.5 x UTD. Using duel treatments, wound closed in 34 days

Case 3:  25 week gestation, 4 weeks old – L hand extravasation 2 x 1.5 x UTD. Using dual treatments, wound closed in 21 days

Case 4: 28 week gestation, 4 weeks old - R ankle extravasation 3 x 4.5 x UTD. Using dual therapy wound closed on 8/9/15 after 41 days

Results: All four cases demonstrated desired debridement and expedited healing.

Photos will be presented.

Conclusion:

ALH provided safe, effective debridement and pH modulation of the wound bed providing what may be an optimal wound bed for DAMA application. 

DAMA expedited wound closure for this sensitive group of neonates with only 2 applications usually required. No untoward effects were noted with this unique and successful protocol.