Trauma and Burn Wound Therapy: A Multi-case Series

Poster Number: CS-086
 
A 2021 press release from the American College of Surgeons noted that the United States is experiencing a surge in injuries, including a significant increase in gunshot wounds. The authors’ trauma center (Regions Hospital, St. Paul, MN) has also seen this increase, including 3 recent gunshot wounds in children younger than 9 years. Two of these incidents were fatal, but the third victim survived. That third case is presented, along with other complex patients, to illustrate advances in trauma and burn wound therapy using hypochlorous acid–preserved wound cleanser (HAPWOC) (Vashe; Urgo North America). The authors report their experience using HAPWOC with and without negative pressure wound therapy with instillation (NPWT-i) on a variety of traumatic and burn wounds. The intent is to validate use of this therapy in healing these complex wounds.

HAPWOC in combination with NPWT-i and wet to dry gauze was used. Six cases are presented, with patients ranging in age from 32 months to 75 years. 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 mm Hg, soak phases ranged from 5 to 10 minutes, and instillation cycles were either 2 or 3.5 hours. The HAPWOC gauze soaks were changed twice daily.
 
Five of 6 patients had complete closure. Four closures were by split-thickness skin grafting, one closed by secondary intention, and one received a rotational flap. Four of these patients were discharged to home.
 
In the authors’ experience, trauma and burn wounds benefit from the use of HAPWOC. The therapy described here was effective in healing complex wounds when used in conjunction with NPWT-i and when HAPWOC was used in wet to dry gauze dressings.

Poster reference:
Babiak R. Trauma and burn wound therapy: a multi-case series. Poster presented at: Symposium on Advanced Wound Care Spring; April 6-10, 2022.