Objective The information on sternal wound management in children after cardiac surgery is limited. The authors formulated a pediatric sternal wound care schematic incorporating concepts of interprofessional wound care and the wound bed preparation paradigm including negative-pressure wound therapy (NPWT) and surgical techniques to expedite and streamline wound care in children.

Methods Authors assessed knowledge about sternal wound care among nurses, surgeons, intensivists, and physicians in a pediatric cardiac surgical unit regarding the latest concepts such as wound bed preparation, NERDS and STONEES criteria for wound infection, and early use of NPWT or surgery. Management pathways for superficial and deep sternal wounds and a wound progress chart were prepared and introduced in practice after education and training.

Results The cardiac surgical unit team members demonstrated a lack of knowledge about the current concepts of wound care, although this improved after education. The newly proposed management pathway/algorithm for superficial and deep sternal wounds and a wound progress assessment chart was introduced into practice. Results in 16 observed patients were encouraging, leading to complete healing and no mortality.

Conclusions Managing pediatric sternal wounds after cardiac surgery can be streamlined through incorporation of evidence-based current wound care concepts. In addition, the early introduction of advanced care techniques with appropriate surgical closure further improves outcomes. A management pathway for pediatric sternal wounds is beneficial.

In this third part of a series of articles (Part I WCET^® Journal Volume 36 Number 2 – April/June 2016: PP29-34; Part II WCET^® Journal Volume 37 Number 3 – July/September 2017: PP20-24) on skin and soft tissue infections (SSTI), cellulitis syndromes are explored. A case-based approach to the diagnosis and management of cellulitis for clinicians is discussed.

One method for treating a retracted stoma is a vacuum dressing that cleans the wound and protects against intestinal leakage. This case series describes the use of an integrated, single-use negative-pressure wound therapy (NPWT) dressing to treat retracted stomas as an alternative to other noninvasive remedies. The report includes seven patients who were hospitalized in the authors’ surgical department from 2019 to 2020. All patients developed severe peristomal infection that failed to respond to local treatment with proper ostomy appliances or specialist dressings. After cleaning each wound and removing necrotic lesions, the authors applied a single-use hydrofiber NPWT dressing to each patient. The dressing was changed every 2 to 5 days, depending on the effects of the therapy. The stoma orifice was covered with a bag with two-piece ostomy systems. The peristomal wound healed in all cases and leakage was eliminated. The mean time of treatment was 14 days (range, 10-21 days), and the vacuum dressings were changed an average of four times (range, 3-7). None of the patients required a stoma translocation or other additional surgery. Three patients received systemic IV antibiotic therapy to treat general infection. Single-use NPWT dressings protect peristomal wounds from bowel leakage and do not hinder the application of stoma bags. This system, similar to standard NPWT devices, effectively protects infected stomas from retraction.