Incision and drainage of subcutaneous gangrene in neonates

Neonatal subcutaneous gangrene is one of the most common serious infections in the neonatal period. Bacteria (mostly Staphylococcus aureus, occasionally Pseudomonas aeruginosa or Streptococcus mutans) cause extensive necrosis in subcutaneous fat and connective tissue. The child has a great threat to life. Lesions often occur in the lumbosacral, back, and buttocks. In addition to improving systemic resistance and controlling infection, the treatment should be adequately drained early in the lesion to reduce the inflammatory tension; it must not wait for fluctuations to occur before the incision and drainage, so as not to lose the opportunity to rescue the child. Treating diseases: neonatal subcutaneous gangrene Indication Neonatal subcutaneous gangrene should be cut open. Contraindications Preoperative preparation 1. Antibiotics should be applied systemically before surgical drainage. 2. 30 to 50 ml of fresh blood should be prepared to supplement the blood loss when the drainage is cut. 3. In order to shorten the operation time and reduce intraoperative oozing, a small Vaseline gauze strip should be prepared before surgery for use in drainage. Surgical procedure 1. Position: The choice of position is convenient for surgery and does not affect the breathing of children. Generally, the prone position is used, one side is raised, and the face is turned to the high side. 2. Skin disinfection: Disinfect twice with 75% alcohol or 1:2000 cleanser. 3. Incision and drainage: In the center of the lesion, use a sharp-edged knife to make a small incision with a length of 1 to 1.5 cm. The distance between the incisions is 2 to 3 cm. The incisions should be staggered and arranged in a sieve shape, and should not be arranged in absolute parallel. Cut and use Vaseline gauze strips to reduce the amount of blood loss in children. It can also be used as an opposite drainage between the two incisions. The incision range should be cut to the edge of the lesion and the normal boundary. Finally wrapped with dressing.