Sound Evidence - October 2008 - (Page 61) A ment, petroleum gauze dressings, topical and systemic antibiotics, and skin grafts.4-6 The authors’ experience using APWT as an adjunct to standard wound care in challenging wounds suggested it might be a viable treatment option for HWS scalp wounds. The major benefits of APWT — nonsurgical debridement and reduction of bioburden in the wound bed — were important considerations in the treatment plan for toddlers with extensive, infected, friable wounds. Conclusion B Results using APWT on HWS-associated scalp wounds illustrate both the potential effectiveness of APWT and the necessity for consistent, long-term treatment of wounds associated with this disorder. Acoustic pressure wound therapy treatments as an adjunct to appropriate wound care may be a valuable option for recalcitrant HWS wounds or other ectodermal dysplasias. - OWM References Rosselli D, Gulienetti R. Ectodermal dysplasia. Br J Plast Surg. 1961;14:190–204. 2. Hay RJ, Wells RS. The syndrome of ankyloblepharon ectodermal defects and cleft lip and palate: an autosomal dominant condition. Br J Dermatol. 1976;94(3):277–289. 3. McGrath JA, Duijf PH, Doetsch V, et al. Hay-Wells syndrome is caused by heterozygous missense mutations in the SAM domain of p63. Hum Mol Genet. 2001;10(3):221–229. 4. Fosko SW, Stenn KS, Bolognia JL. Ectodermal dysplasia associated with clefting: significance of scalp dermatitis. J Am Acad Dermatol. 1992;27(20):249–256. 5. Lodha A, Ng E. A neonate with denuded skin: Hay-Wells syndrome. CMAJ. 2004;171(2):131. 6. Vanderhooft SL, Stephan MJ, Sybert VP. Severe skin erosions and scalp infections in AEC syndrome. Pediatr Dermatol. 1993;10(4):334–340. 7. Lai J, Pittelkow MR. Physiological effects of ultrasound mist on fibroblasts. Int J Dermatol. 2007;46:587–593. 8. Unger P. Low-frequency, noncontact, nonthermal ultrasound therapy: a review of the literature. Ostomy Wound Manage. 2008;54(1):57–60. 9. Kavros SJ, Schenck EC. Use of noncontact low-frequency ultrasound in the treatment of chronic food and leg ulcerations: a 51-patient analysis. J Am Podiatr Med Assoc. 2007;97(2):95–101. 10. Gehling ML, Samies JH. The effect of noncontact, low-intensity, low-frequency therapeutic ultrasound on lower-extremity chronic wound pain: a retrospective chart review. Ostomy Wound Manage. 2007;53(3):44–50. 1. Figure 3a,b. The twins (girl, a; boy, b) after 37 treatments with acoustic pressure wound therapy (August 2008). Sporadic APWT and specialty wound care due to health and family issues resulted in rapid deterioration of the wounds. Discussion As of August 2008, 3-year-old twins with HWS-associated scalp wounds since infancy have received 7 months of APWT treatments. After the first 5 weeks of consistent weekly APWT, the wounds were predominantly granulated with evidence of epithelial progression and no signs of infection. Unfortunately, multiple health and family issues did not allow for either consistent APWT or specialty wound care, resulting in deterioration of the wounds. The medical literature provides scant information on the treatment of HWS wounds.2,4-6 Previous treatments for this rare disorder have included surgical debride- October 2008 Vol. 54 Issue 10 61
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.