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The Burden of Pediatric Chronic Wounds: A Systematic Review

Ayesha A Qureshi, MD Catherine Kennedy, BHSc Jenny Barker, MD PhD
Nationwide Children's Hospital Abigail Wexner Research Institute
2024-01-14

Presenter: Ayesha A Qureshi MD

Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The submitted work represents the original work by the student, Ayesha A Qureshi.

Director Name: Jenny Barker

Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction

INTRODUCTION:
Chronic wounds impact 10.5 million people annually in the United States. Studies have highlighted a recent surge in chronic wound cases among the younger population; however, the collective burden of pediatric chronic wounds remains unknown. This study aims to describe the epidemiology and management of pediatric chronic wounds.

METHODS:
The literature search spanned Embase, PubMed, and Web of Science databases. Inclusion criteria encompassed articles published after 2000, which specified chronicity of wounds in pediatric patients. Case reports, review articles, and proceedings were excluded.

RESULTS: A total of 19 articles were included. Pilonidal sinus disease was the most frequent chronic wound etiology (62.8%), followed by burns (24.9%). Trauma (4.2%), nontuberculous mycobacterium (4.8%), epidermolysis bullosa (2.2%), pressure ulcers (0.3%), and osteomyelitis (0.8%) comprised smaller proportions.

Six studies explored the epidemiology (31.6%), assessing malnutrition, racial differences, atypical diagnostic considerations, and comorbidities such as myelomeningocele. A 10-year national database study found 4,794,482 pediatric chronic wound hospitalizations due to pyoderma gangrenosum. Most studies focused on chronic wound management (79%), commonly showing efficacy for negative pressure wound therapy, flap procedures, and nutritional considerations. One study showed that virtual reality distraction significantly reduced pain during dressing changes and another highlighted self-management and educational initiatives.

CONCLUSIONS:
This is the first systematic review to assess the overall burden of pediatric chronic wounds. Addressing this public health concern necessitates a more equitable allocation of resources towards research focused on prevention and enhanced treatment strategies.

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