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Cutis Aplasia in Bart's Syndrome: Innovative Use of Negative Pressure Wound Therapy in Two Neonatal Cases
Simran Chandawarkar B.S.
Helen Hannan
Ibrahim Amjad MD, MBA
Northeast Ohio Medical University
2025-01-10
Presenter: Simran Chandawarkar
Affidavit:
This is original work conducted by students on our research team.
Director Name: Ibrahim Amjad
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction:
Bart's Syndrome, a rare subtype of epidermolysis bullosa (EB), is characterized by congenital skin absence, nail deformities, and mucous membrane blistering, with no standardized treatment. This report highlights two neonatal cases successfully managed with a novel approach using negative pressure wound therapy (NPWT) to accelerate epithelialization.
Patient One:
At birth, Patient One presented with EB and extensive skin loss and bilateral dermal and epidermal exposure from the knees to the toes noted by 12 hours of life. NPWT was initiated at 75mmHg with a Mepitel® contact-layer with dressing changes three times weekly. Epithelialization began at two weeks, transitioning to Adaptic™ dressings. Full epithelization was achieved by three weeks, followed by progression to Mepitel®-transfer and Kling dressings.
Patient Two:
Patient Two presented at birth with EB and bilateral cutis aplasia of the lower extremities. After transfer to our tertiary care center, NPWT with Mepitel® and black foam at 125mmHg was initiated at one-day of life. Epithelialization was noted at 2.5 weeks, transitioning to Adaptic™ dressings. Full closure was achieved after an additional week of therapy. Both patients were followed post-treatment without complications.
Discussion:
Treatment of Bart's Syndrome focuses on wound closure and minimizing infection/complications. Conservative approaches require months for healing and frequent dressings whereas NPWT accelerates wound healing by using vacuum pressure to remove fluids and debris. This reduces dressing changes and thus lowers infection risk in an already vulnerable population.
Conclusion:
NPWT successfully reduced hospitalization time and mitigated fluid complications, offering a cost-effective alternative for neonates with Bart's Syndrome.
