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CC BY-NC 4.0 · Arch Plast Surg 2021; 48(03): 338-343
DOI: 10.5999/aps.2020.01032
Research/Experimental
Case Report

The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant

Benjamin Kah Liang Goh 
Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Singapore
,
Alvin Wen Choong Chua 
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
,
Khong Yik Chew 
Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Singapore
,
Gavin Chun-Wui Kang 
Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Singapore
,
Li-Wei Chiang
Department of Paediatric Surgery, KK Women’s and Children’s Hospital, Singapore
,
Bien-Keem Tan 
Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
,
Savitha Ramachandran 
Department of Plastic, Reconstructive and Aesthetic Surgery, KK Women’s and Children’s Hospital, Singapore
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Abstract

Purpura fulminans is a serious condition that can result in severe morbidity in the pediatric population. Although autologous skin grafts remain the gold standard for the coverage of partial- to full-thickness wounds, they have several limitations in pediatric patients, including the lack of planar donor sites, the risk of hemodynamic instability, and the limited graft thickness. In Singapore, an in-house skin culture laboratory has been available since 2005 for the use of cultured epithelial autografts (CEAs), especially in burn wounds. However, due to the fragility of CEAs, negative-pressure wound therapy (NPWT) dressings have been rarely used with CEAs. With several modifications, we report a successful case of NPWT applied over a CEA in an infant who sustained 30% total body surface area full-thickness wounds over the anterior abdomen, flank, and upper thigh secondary to purpura fulminans. We also describe the advantages of using NPWT dressing over a CEA, particularly in pediatric patients.

Keywords

Negative-pressure wound therapy - Autografts - Epithelium cells - Child - Skin

This case was presented as a poster at the 10th Congress of the World Society of Reconstructive Microsurgery, on June 12–15, 2019, in Bologna, Italy.




Publication History

Received: 30 May 2020

Accepted: 10 July 2020

Article published online:
21 March 2022

© 2021. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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