Epidermolysis Bullosa

One of the most rewarding aspects of wound care has been the care of children with complex wounds whether due to trauma or congenital disorders of the skin. We have partnered with the Shiners Hospital in Erie to provide the most advanced wound care to our pediatric patients. The case examples below illustrate some of the challenges we have overcome in this population.

Epidermolysis bullosa is a group of rare disorders of the skin in which the epidermis is not properly attached to the dermis. Children with this condition develop serious wounds after minimal trauma.

We have applied bioengineered skin and tried silver containing garments. Currently we are testing a new growth factor in patients with EB at our Erie clinic.

For more information about this trial, contact us.

 

Childhood Hemangioma

Thomas Serena MD FACS was honored at the international congress of the Society for Advanced Wound Care (SAWC) for his novel treatment of a segmental infantile hemangioma. As a result, he was named as the Vascular Birthmark Foundation’s “wound care expert” and is consulted by physicians across the US on difficult hemangioma-related wounds.

Bella was born on Dec 11, 2006 after an uneventful pregnancy. Shortly after birth her mother noted a faint pink hue on the left side of her face. Over the first month of her life, the pink hue grew rapidly into a large hemangioma. By one month of age, the hemangioma interfered with her vision and created significant health concerns. The lesion failed to respond to oral steroids and laser therapy.

In May 2007, Bella presented to the our wound clinic with a necrotic wound in the central portion of the lesion measuring 42cm. The wound was painful and bled easily.

Our initial plan was to remove the necrotic tissue to prepare the wound for grafting with bioengineered skin or other advanced wound care techniques. Sharp debridement was not an option due to the risk of bleeding.

In an ongoing clinical trial, we were realizing some success in using noncontact, low-frequency ultrasound for painless debridement in adult patients with arterial and venous leg ulcerations. But would this novel treatment work on an infant? We designed a patient protocol. Success was almost immediate. The wound healed within six weeks and the hemangioma resolved.

The discovery of this new technique will hopefully help children with hemangiomas across the world.