Abstract
Burns in the neonatal period are rare and most commonly due to iatrogenic causes. We report a case of a preterm neonate who sustained a full thickness electrical burn following the use of a temporary pacing pad. The case was complicated by significant co-morbidities and the need for cardiac surgery. We describe the surgical management of the case, using excision and closure in the form of a W-plasty. We discuss the reasons for this surgical decision and the importance of managing complex cases such as this on an individual basis.
Highlights
Case historyA female infant weighing 1.1kg was born at 34 weeks’ gestation by emergency Caesarean section due to foetal bradycardia and worsening hydrops
Burns in the neonatal period are rare and most commonly due to iatrogenic causes
We present a case of a full thickness electrical burn due to the use of external pacing in a preterm neonate
Summary
A female infant weighing 1.1kg was born at 34 weeks’ gestation by emergency Caesarean section due to foetal bradycardia and worsening hydrops. There was a prenatal diagnosis of congenital heart block and structural heart disease. The heart rate of 70–90 beats per minute provided adequate cardiac output. At 2 days old, the baby had a heart rate of 30–45 beats per minute associated with hypotension unresponsive to medical treatment. Intravenous pacing was unsuccessful so a decision was made to perform transthoracic external cardiac pacing before performing definitive cardiac surgery and inserting pacing wires. Paediatric transcutaneous pacing pads were placed on the anterior chest and back of the infant. Good capture was achieved and demand pacing was commenced with an immediate improvement in cardiac output.
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