Epidermal Necrosis of Forearm and Wrist due to Extravasation of Sodium Bicarbonate and Application of Epidermal Growth Factor for Therapy in Extremely Low Birth Weight Infant

Extravasation occurs when an intravenous drug is inadvertently administered into the perivascular space or subcutaneous tissue. This can have various consequences, from local irritation to severe tissue loss. Extravasation occur more frequently in neonatal populations, especially in younger gestational ages and with lower birth weights. There is no established method of treatment for extravasation. Conservative treatments such as saline wash, wet dressing, hyaluronidase, and hydrogel dressing should be performed. Recently, two full-term newborns have been reported to successfully treat skin necrosis with recombinant human basic fibroblast growth factor. We report for the first time that extravasation in extremely very low birth weight infants can be successfully treated with recombinant human epidermal growth factor.