Management of Aplasia Cutis Congenita in Neonates: The Role of Topical Leptospermum Honey

BACKGROUND: Aplasia cutis congenita (ACC) is an uncommon, heterogeneous group of disorders characterized by focal or widespread absence of skin from certain parts of the body. Complications of ACC include infections, meningitis, bleeding, sagittal sinus thrombosis, and seizures with a mortality rate ranging from 20% to 50%. Mortality increases with larger defects and those involving the underlying bone. There is no consensus on best treatment of ACC. 

OBJECTIVE: The author reports the successful closure of ACC lesions utilizing topical active Leptospermum honey (ALH) and proposes a successful conservative regimen with topical ALH, adhering to pillars of wound healing and avoiding toxic exposures to systemic antibiotics, silver, and topical antibiotics.

MATERIALS AND METHODS: Full-term neonates with various presentations of syndromic and nonsyndromic ACC lesions were included. A conservative approach was taken in the care of the lesions, in accordance with appropriate wound care principles and desire for a natural treatment for this fragile population. By upholding principles of good wound care, including a moist wound base, antimicrobial coverage, gentle autolytic debriding effect, and promotion of new tissue growth, the authors utilized topical ALH twice daily and covered the defects with a secure dressing. 

RESULTS: Hospital stays were short and without complications. Parents were educated on proper wound care. All lesions progressed to complete closure. Time to closure was either similar or shorter in comparison with previously published data.

CONCLUSIONS: Aplasia cutis congenita is a rare, often isolated but potentially serious defect that does not have strong evidence-based treatment guidelines. Surgical approach can lead to complications and increased mortality. Herein, the author found ALH to be a great catalyst in fostering wound healing, even in larger defects.

CITATION
Boyar V. Management of aplasia cutis congenita in neonates: the role of topical Leptospermum honey. Poster presented at: Symposium on Advanced Wound Care Fall; November 2-4, 2018; Las Vegas, NV.

Product: MEDIHONEY (Integra LifeSciences, Plainsboro, NJ)

This abstract was not subject to the WOUNDS peer-review process.