Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2019; 7(17): 2611-2616
Published online Sep 6, 2019. doi: 10.12998/wjcc.v7.i17.2611
Treating aplasia cutis congenita in a newborn with the combination of ionic silver dressing and moist exposed burn ointment: A case report
Guo-Feng Lei, Jun-Ping Zhang, Xiao-Bing Wang, Xiao-Li You, Jin-Ya Gao, Xiao-Mei Li, Mei-Ling Chen, Xiu-Qin Ning, Jiang-Li Sun
Guo-Feng Lei, Jun-Ping Zhang, Xiao-Bing Wang, Xiao-Li You, Xiao-Mei Li, Xiu-Qin Ning, Department of Neonatal Intensive Care Unit, Sanmenxia Central Hospital, Sanmenxia 472000, Henan Province, China
Jin-Ya Gao, Jiang-Li Sun, Department of Intensive Care Unit, Sanmenxia Central Hospital, Sanmenxia 472000, Henan Province, China
Mei-Ling Chen, Reproductive endocrine center, Sanmenxia Central Hospital, Sanmenxia 472000, Henan Province, China
Author contributions: Lei GF made the manuscript preparation, literature review, contributed to the diagnosis and provided clinical assistance; Zhang JP, Wang XB, You XL, Gao JY, Li XM, Chen ML, Ning XQ and Sun JL made the study design, manuscript correction, contributed to the diagnosis and provided clinical assistance. All authors approved the final version of the manuscript.
Informed consent statement: Written informed consent was obtained from each patient’s parent for the publication of this report and ac-companying images
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Guo-Feng Lei, MD, Attending Doctor, Department of Neonatal Intensive Care Unit, Sanmenxia Central Hospital, Xiaoshan Road, Sanmenxia 472000, Henan Province, China. leiguofeng1981@sina.com
Telephone: +86-15036469906Fax: +86-398-2933151
Received: March 14, 2019
Peer-review started: March 15, 2019
First decision: July 30, 2019
Revised: August 9, 2019
Accepted: August 20, 2019
Article in press: August 20, 2019
Published online: September 6, 2019
Processing time: 177 Days and 22.5 Hours
Abstract
BACKGROUND

Aplasia cutis congenita (ACC) in newborns is a condition in which congenital defects or hypoplasia is present in part of the epidermis, dermis and even subcutaneous tissue (including muscle and bones). First reported by Cordon in 1767, ACC is a rare disease with a low incidence of 1/100000 to 3/10000. Currently, there are 500 cases reported worldwide. ACC can be accompanied by other malformations. The onset mechanism of the disease remains unknown but is thought to be correlated to factors such as genetics, narrow uterus, foetal skin and amniotic membrane adhesion, use of teratogenic drugs in early pregnancy and viral infection.

CASE SUMMARY

In August 2018, we treated a newborn with ACC on the left lower limbs using a combination of ionic silver dressing and moist exposed burn ointment (MEBO) and achieved a satisfactory treatment outcome. The skin defects were observed on the external genitals and on areas from the left foot to 3/4 of the upper left side. Subcutaneous tissue and blood vessels were observed in the regions with skin defects. The following treatments were provided. First, the wound was rinsed with 0.9% sodium chloride solution followed by disinfection with povidone-iodine twice. And then MEBO was applied to the wound at a thickness of approximately 1 mm. After applying ionic silver dressing, the wound was covered with sterile gauze. The wound dressing was replaced every 2-3 d. At the 4-mo follow-up, the treatment outcome was satisfactory. There was minimal scar tissue formation, and limb function was not impaired.

CONCLUSION

The combination of ionic silver dressing and MEBO to ACC is helpful.

Keywords: Aplasia cutis congenita; Newborns; Ionic silver dressing; Moist exposed burn ointment

Core tip: Aplasia cutis congenita (ACC) is a rare disease in China and abroad. There is not yet a well-developed treatment for this disease. Combination of ionic silver dressing and moist exposed burn ointment in treating ACC is an useful and effective method. This treatment is worthy of being promoted in clinical practice.