Case Series of Neonatal Extravasation Injury: Importance of Early Identification and Management

Abstract

Extravasation injury is a common iatrogenic injury, especially in neonates. Intravenous access is essential in neonatal care, but neonatal extravasation injury is associated with severe morbidity. We present three cases of neonatal extravasation injuries with varying presentations, etiological agents, and timing of management. It shows that extravasation injuries treated with the saline flush-out technique and timely intervention have a superior outcome with almost immediate resolution and subsequent healing with no scars. This is in stark contrast with the lesions treated conservatively with dressings that took more time to heal. We are reminded to be vigilant with infusion therapies and the importance of early detection and prompt treatment in neonatal extravasation injuries.

Keywords: cannula; dressing; extravasation injury; extravasation of diagnostic and therapeutic materials; gault technique; intravenous fluid; necrosis; neonate; newborn; saline flush-out.

Figure 1. Antecubital fossa full-thickness skin loss with surrounding erythematous wound edge.

Figure 2. Area of induration over the left distal medial thigh, with redness and warmth.

Figure 3. Antecubital fossa wound healed via secondary intention after six weeks.

Figure 4. Left distal medial thigh puncture wound healed with no visible scars.

Figure 5. Left hand swollen with an area of discoloration at dorsum and surrounding erythema.

Figure 6. Left palm grossly swollen with erythema.

Figure 7. Area of necrosis demarcated with minimal intact blisters and surrounding erythema.

Figure 8. Dry necrotic patch over the left-hand dorsum.

Figure 9. Left-hand dorsum swollen, erythematous with hemoserous discharge.

Figure 10. Swelling resolved with minimal residual erythema.