Etiology and features of the course of the wound process in neonates

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Abstract

Introduction. Despite the significant progress made in recent decades in reducing the mortality rate, the risks of adverse outcomes in infectious and inflammatory soft tissue diseases in newborns are still high. The high-risk group consists of children from mothers with a pre-morbid background, as well as premature infants with intrauterine hypoxia and intracranial birth trauma. Traumatization and infection can also occur during medical manipulations (tracheal intubation, vascular catheterization, damage to the baby’s skin during obstetrical procedures, etc.). The variety of pathological processes that cause wounds of different etiology is due to the anatomical and physiological features of the skin of newborns. In addition, neonatal skin lesions may be a manifestation of systemic diseases and may themselves be the cause of manifestation.

Materials and methods. Medical records of 147 neonates treated in infectious and burn units of Speransky Children’s City Clinical Hospital №9 were analyzed. Clinical examples of children in the first month of life with wounds of various etiologies are presented.

Conclusion. Treatment of newborn infants with inflammatory processes of the skin and underlying tissues of different etiology requires multidisciplinary approach with the involvement of not only surgical specialists.

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About the authors

Anna A. Avanesyan

Speransky Children’s City Clinical Hospital №9

Author for correspondence.
Email: anny271992@mail.ru
ORCID iD: 0000-0003-1565-9003

paediatric surgeon

Russian Federation, Moscow

Tatiana S. Astamirova

Speransky Children’s City Clinical Hospital №9

Email: tastamirova@yandex.ru

paediatric surgeon

Russian Federation, Moscow

Liudmila I. Budkevich

Speransky Children’s City Clinical Hospital №9; Pirogov Russian National Research Medical University

Email: budkevich@yandex.ru

D. Sci. (Med.), Prof.

Russian Federation, Moscow; Moscow

References

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Supplementary files

Supplementary Files
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1. Fig. 1. The girl, 7 days old: a – burn of the 2–3rd degree of hot fluid in the right side of the face in the area of 3% of body surface; b – view of the wound on the 3rd day after the injury before surgical necrectomy; c – wound surface after removal of necrotic tissue (3rd day); d – the forming hypertrophic scar 1 month after the injury.

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2. Fig. 2. The boy A., 14 days old: a – soft tissue necrosis in the left forearm; b – wound appearance on the 8th day; c – complete wound epithelialization after local conservative treatment (16th day).

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3. Fig. 3. Boy, 8 days old: a – dry gangrene of the right hand (3 days); b – dry gangrene of the left hand (3 days); c –7-day postoperative intervention (necrectomy, exarticulation).

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4. Fig. 4. The infant born at term with a birth weight of 3800 g: a – areas of hemorrhagic necrosis in the lower extremities, in the crotch (3 days of life); b – wounds after partial detachment of devitalized tissues (21 days of life); c – type of granulation wounds after removal of dry crust (23 days of life); d – complete epithelialization of the wounds on the 28th day of hospital treatment.

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