Reducing bioburden to facilitate healing in three unique and rare pediatric wounds

In a Mid-Western tertiary children’s hospital, three children were identified with rare and unusual wounds.   In order to  prevent and reduce bioburden at the wound sites, each child was treated with a fatty acid derivative in DACC ( Dialkylcarbamoyl chloride)  technology dressing to irreversibly bind with bacteria, without releasing endotoxins, through hydrophobicity action.

A 10 year old male with history of hepatosplenomegaly and pancytopenia was admitted for a procedure. He presented with a chronic scalp wound from previous cranial surgeries beginning at age three. Locally managed with no long term success, WOC team was consulted.  Debris was removed from the scalp and a moist dressing with DACC technology was applied then covered with dry gauze. 24 hours later, the dressing was painful to remove. Modifications were made by adding  a silicone sheet contact layer, DACC dressing, then moist gauze  secured  with elastic netting.  Within two months he was readmitted and successfully grafted.  

A 15 year old female was admitted with relapsed acute lymphatic leukemia. Her course was complicated with pseudomonas bacteremia and ecthyema gangrenosum of the genitalia while immunocompromised. WOC team treated with DACC technology to reduce presence of microorganisms.  Her course of therapy resulted in surgical debridement then ultimately grafting of her genitalia. DACC technology was utilized again in combination with negative pressure wound therapy. Area  completely healed in two months.

A 39 week old male with congenital diagraphmatic hernia and E.coli sepsis developed purpura fulminans on the head, neck trunk scrotum and arms. The skin was very friable and weeping serosanguinous fluid.  Bacteriostatic petroleum  gauze was initially used for treatment.  With WOC team involvement therapy was changed to DACC technology dressing with silicone foam as a secondary.  Wounds began to contract and heal with discussion of skin grafting. Unfortunately, he  suffered multi-system organ failure and passed away.