Cutaneous complications of central umbilical artery catheterization

Central umbilical artery catheterization, currently a widely used procedure in neonatal intensive care units, is accompanied by a substantial risk of vascular complications. Unilateral skin necrosis of the buttock was the initially seen manifestation of vascular occlusion secondary to thromboembolic phenomena or direct vascular damage from central umbilical artery catheterization in a premature male infant. Skin findings, such as transient blanching or erythema in a neonate who has had umbilical artery catheterization, can precede the evolution of gangrene and necrosis. One should be alert to the possibility of a vascular basis for lesions in infants in whom indwelling umbilical artery catheters have been used.