Effectiveness of Debridement Treatment in Neonatorum Epidermolysis Bullosa: A Case Report

Abstract

Introduction: Epidermolysis Bullosa (EB) is an autosomal genetic disorder that characterized by blistering of the skin and mucosa following mild trauma such as frictional trauma. There is no definitive treatment has yet to be developed. The goal of surgical debridement is to achieve a clean wound bed in fastest way, reduce bacterial burden, remove as much nonvital tissue, speed up the healing process, which will shorten the length of stay in hospital. Case Finding: We have 3 days old newborn with clinical appearance similar to a second degree burn lesion bullous lesions and epidermal damage on her both feet, gluteal, and genital regions but without previous history of contact with thermal trauma consulted to patients. General physical examination showed no fever and vital within normal condition. In the perinatal history, the baby was delivered by caesarean section from a 37 years-old G3P2A0 mother with preeclampsia comorbid, normal gestational age, her birth weight was 3800 grams, her birth length was 51 cm, and with APGAR her scores of were 9 and 10 the 1st and 5th minute respectively. Our newborn patient was looked like 2nd degree burn injury with blisters and epidermolysis but without previous history of contact with thermal trauma. Consulted to plastic surgeon for further evaluation and management. The Baby was discharged day 9 or after 3 days debridement management in stable condition. Conclusion: The surgical debridement demonstrated greatly effective and efficient in achieving these aims. Observation on day 3 did not reveal any sign of infection, showing controlled symptoms and good healing process. We suggest that performing debridement on Epidermolysis Bullosa (EB) patient would shorten the duration of hospitalization. Therefore, it provides low-risk nosocomial infection and low-cost hospitalization.