Treatment of severe extravasation injury in a newborn by using tilapia fish skin: A case report

INTRODUCTION AND IMPORTANCE: Peripheral venous catheterizations in newborns are associated with complications such as infections, phlebitis, vessel rupture and drug leaks or serum. Extravasation injury refers to the leakage of injected drugs from blood vessels causing damage to the surrounding tissues, skin necrosis, and sometimes amputation. Using tilapia fish skin (TFS) is one of the new strategies that have been used in wound management. CASE PRESENTATION: This case is a 36-week- and 4-day-old male fetus with a birth weight of 1600 g, height of 40 cm, and head circumference of 31 cm who was born to a 25-year-old mother by cesarean section at Mahzad Obstetrics and Gynecology Hospital, Urmia, Iran. On the third day of hospitalization at neonatal intensive care unit (NICU), an extravasation injury occurred in the infant's left hand in size approximately 1 × 1 cm by peripheral catheter. Despite extensive intravenous antibiotic therapy and rinsing with normal saline, wound healing was not achieved. The necrotic area was bandaged by using of the tilapia skin. For this purpose, the area was first washed with normal saline for 5 min and then the tilapia skin was placed on the damaged skin for 10 days. After a month, the newborn's wound had completely healed. CLINICAL DISCUSSION: Infants are more prone to extravasation injury than adults due to being more sensitive and thinner peripheral vessel walls. CONCLUSION: This case illustrates that tilapia fish skin may be a suitable alternative to other temporary skin cover dressings in premature newborns suffering from extravasation injury.