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Alcohol burns in the neonate
1Department of Paediatrics, Mercy Hospital for Women, Melbourne, Australia.
Insights
Extremely low birthweight infants are vulnerable to severe chemical burns from alcohol skin prep solutions due to their permeable skin. Careful selection and use of disinfectants are crucial in neonatal units to prevent these injuries.
Area of Science:
- Neonatal care
- Dermatology
- Chemical safety
Background:
- Neonatal intensive care units (NICUs) commonly use alcoholic solutions for skin disinfection before procedures.
- Infant skin, particularly in extremely low birthweight (ELBW) neonates, possesses unique physiological characteristics.
Observation:
- Two case histories detail infants experiencing chemical burns after contact with alcoholic skin preparation solutions.
- Exposure duration was relatively brief, highlighting the rapid absorption and potential for injury in ELBW infants.
Findings:
- ELBW infants exhibit increased skin permeability, making them highly susceptible to chemical burns from standard antiseptic agents.
- Alcoholic solutions can cause significant dermal injury in neonates even with short application times.
Implications:
- Enhanced vigilance is required in selecting and applying skin disinfection agents in the neonatal setting.
- Clinical protocols for skin antisepsis in ELBW infants may need revision to mitigate burn risks.
- Further research into alternative, safer skin preparation methods for vulnerable neonates is warranted.
Abstract:
The case histories of two infants who sustained chemical burns due to contact with alcoholic skin preparation solutions are presented. The skin permeability of the extremely low birthweight infant renders them susceptible to major burns following relatively brief exposure to such solutions. Care is needed in the selection and use of skin disinfection solutions in the neonatal nursery.