Subcutaneous fat necrosis requiring plastic surgical intervention in an infant treated with whole-body cooling

JPRAS Open. 2018;15(C):61-65 DOI 10.1016/j.jpra.2017.10.006

 

Journal Homepage

Journal Title: JPRAS Open

ISSN: 2352-5878 (Online)

Publisher: Elsevier

Society/Institution: British Association of Plastic, Reconstructive and Aesthetic Surgeons

LCC Subject Category: Medicine: Surgery

Country of publisher: United Kingdom

Language of fulltext: English

Full-text formats available: PDF, HTML

 

AUTHORS

Leonie Heskin (Plastic Surgery Department, Frenchay Hospital, Bristol, UK)
Muhammad Adil Abbas Khan (Plastic Surgery Department, Frenchay Hospital, Bristol, UK)
Poh Hua Ho (Plastic Surgery Department, Frenchay Hospital, Bristol, UK)
Tim Burge (Plastic Surgery Department, Frenchay Hospital, Bristol, UK)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 22 weeks

 

Abstract | Full Text

We report an infant who developed subcutaneous fat necrosis of the newborn (SCFN) secondary to cooling treatment for hypoxic ischaemic encephalopathy (HIE). While SCFN is usually self-limiting, this patient went on to develop a large haematoma on his back with overlying skin necrosis necessitating debridement and split thickness skin grafting. Initially, the area affected on his back showed a number of small fluctuant swellings. By day 16 after birth, theses swellings coalesced to form a large 15 cm × 19 cm haematoma with a tense, shiny skin overlying it. On day 17, the large swelling was drained in theatre and a drain was left in situ. Total calcium blood level was raised at 4 mmol/l and he was managed with Pamidronate infusion. Postoperatively, examination of the back showed a 5 cm necrotic area in the centre of the back, and affected area was debrided along with a split skin graft applied to the exposed area.