Necrotic phlegmon of newborns

Necrotic phlegmon of newborns is an acute purulent inflammation of the skin and subcutaneous tissue in babies during the first weeks of life.

The reasons

The skin of a newborn baby is very delicate and easily vulnerable. With insufficiently good care, when diaper rash, areas of maceration and individual purulent foci are found (and the skin cannot perform its protective function), when an infection penetrates microcracks in the skin, as well as urine and feces residues, all conditions are created for the occurrence of phlegmon. The causative agent of the disease is mainly staphylococcus, however, phlegmon of newborns can also develop due to the penetration of streptococcus, diplococcus, etc. through the skin.


The disease begins acutely with an increase in temperature to 38-39 gr. C. The phenomena of intoxication are rapidly growing; the baby’s anxiety is replaced by lethargy, he refuses to eat. The skin becomes gray in color, a marble pattern appears. Characterized by frequent shallow breathing, tachycardia, muffled heart sounds, increased blood leukocytosis.

Already in the first hours of the disease, a delimited area of ​​hyperemia and induration is found on the skin, painful on palpation. The skin over the lesion is hot to the touch, does not fold. After 8-12 hours, the affected area increases by 2-3 times, the skin over it acquires a cyanotic tint, and swelling of the surrounding tissues appears. Gradually, softening appears in the center of the focus of infiltration. In some cases, skin necrosis begins, its rejection with the formation of extensive wound defects. The bottom of the wound is gray with remnants of dead tissue, the edges are undermined, uneven, granulations are absent. This type of wound makes the baby suspect the development of sepsis. With a favorable course, after the rejection of dead skin, small wounds (3-6 cm in diameter) are formed, which are gradually filled with granulations, gradually epithelializing along the edges. In the future, at the site of the wound defect, rough scars often form, causing deformation of the chest, lumbar lordosis and kyphosis, which progresses with the growth of the baby.


The differential diagnosis is carried out with erysipelas, aseptic necrosis of the fiber.


Surgical treatment. Under local or general anesthesia, multiple skin incisions are made in a checkerboard pattern above the lesion and along the border with healthy skin. A bandage with a hypertonic solution and an antiseptic (furatsilin, dioxidin) is applied to the entire surface of the lesion for 2-3 hours. In subsequent dressings, the spread of the necrotic process is monitored and, according to indications, additional incisions are made. Subsequently, ointment dressings, ultraviolet irradiation, UHF therapy are used. Intensive therapy is carried out, which includes detoxification, antibacterial and immunostimulating measures.

With a favorable course of the process of rejection of dead skin, a small wound appears, which is gradually filled with granulations.

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