Subcutaneous fat necrosis requiring plastic surgical intervention in an infant treated with whole-body cooling. (March 2018)

• Record Type: Journal Article
• Authors: Heskin, Leonie; Khan, Muhammad Adil Abbas; Ho, Poh Hua; Burge, Tim
• Is Part Of: JPRAS open. Volume 15(2018)
• Page Start: 61
• Page End: 65
• Publication Date: 2018-03
• Subjects: Subcutaneous fat necrosis -- Infant -- Newborn -- Hypercalcaemia; Surgery, Plastic -- Great Britain -- Periodicals; 617.9505
• DOI: 10.1016/j.jpra.2017.10.006
• Languages: English
• ISSNs: 2352-5878

Abstract

Abstract: 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.