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Trauma and Burn Wound Therapy: A Multi-case Series
Introduction: A 2021 press release from the American College of Surgeons notes that we are experiencing a national surge in injuries, including a significant increase in gunshot wounds. Our trauma center has felt this sharp increase including three recent gunshot wounds in children under the age of nine.
Two of these incidents were fatal, but fortunately, the third victim survived. We present her case along with other complex patients to illustrate advances in trauma and burn wound therapy using hypochlorous acid-preserved wound cleanser (HAPWOC). We report our experience including a variety of traumatic and burn wounds. Our intent is to validate the use of this therapy for healing these complex wounds.
Methods: We utilized HAPWOC in combination with NPWT-i and wet to dry gauze. We present six case outcomes in patients aged from 32 months to 75 years. The injuries include a gunshot wound, blast injury, motorcycle crash, crush injury, motor vehicle crash, and an industrial pressure washer injury. The NPWT-i settings ranged from pressures of -50 to -150 mmHg, soak phases ranging from 5 to 10 minutes, and instillation cycles of either 2 or 3 ½ hours. The HAPWOC gauze soaks were changed twice daily.
Results: Of the 6 patients presented, 5 have complete closure. Four closures were by split-thickness skin grafting, one closed by secondary intention, and one will receive a rotational flap. Four of these patients have been discharged home.
Discussion: In our experience, trauma and burn wounds benefit from the use of HAPWOC. We find this therapy effective in healing complex wounds when used in conjunction with NPWT-i and when HAPWOC is used in wet to dry gauze dressings. Although more research is needed, a multidiscipline team versed in the use of these technologies appears to provide excellent outcomes.
References
IntroductionA 2021 press release from the American College of Surgeons notes that we are experiencing a national surge in injuries, including a significant increase in gunshot wounds. Our trauma center has felt this sharp increase including three recent gunshot wounds in children under the age of nine. Two of these incidents were fatal, but fortunately the third victim survived. We present her case along with other complex patients to illustrate advances in trauma and burn wound therapy using hypochlorous acid preserved wound cleanser (HAPWOC). We report our experience including a variety of traumatic and burn wounds. Our intent is to validate use of this therapy for healing these complex wounds. MethodsWe utilized HAPWOC in combination with NPWT-i and wet to dry gauze. We present six case outcomes in patients aged from 32 months to 75 years. The injuries include a gunshot wound, blast injury, motorcycle crash, crush injury, motor vehicle crash, and an industrial pressure washer injury. The NPWT-i settings ranged from pressures of -50 to -150 mmHg, soak phases ranging from 5 to 10 minutes, and instillation cycles of either 2 or 3 ½ hours. The HAPWOC gauze soaks were changed twice daily. ResultsOf the 6 patients presented, 5 have complete closure. Four closures were by split thickness skin grafting, one closed by secondary intention, and one will receive a rotational flap. Four of these patients have discharged to home. DiscussionIn our experience, trauma and burn wounds benefit from the use of HAPWOC. We find this therapy effective in healing complex wounds when used in conjunction with NPWT-i and when HAPWOC is used in wet to dry gauze dressings. Although more research is needed, a multidiscipline team versed in the use of these technologies appear to provide excellent outcomes.
