The childhood scars of newborn intensive care.

Many of the techniques used in newborn intensive care damage the skin and may lead to scarring. We have investigated a cohort of consecutive survivors of newborn intensive care for the presence of scars. Ninety of the original 100 children between the ages of 8 and 9 years were examined in detail by a single observer--the number, site and severity of the scars were noted and compared with the findings when the children were 2 years old. There was an overall reduction in the number of scars with time, regardless of gestational age. Scars from needlemarks were reduced by 41% and those from intravenous accidents by 70%, compared with those seen at 2 years. Scars from chest drains were still visible, in two cases requiring corrective surgery. Nine children and their families found that the scars caused them embarrassment. The only scars which did not usually improve with time and which were often judged to be worse cosmetically were those caused by surgery.

The scars of newborn intensive care.

Many techniques used in neonatal intensive care are invasive and the risk of producing skin damage is high. To investigate this, 100 consecutive survivors of neonatal intensive care (gestation 26-42 weeks, median 32) were examined in detail by a single observer at 16-29 months of age, and the scar severity, site and likely cause noted. Scarring was present in all infants although it was usually trivial. The total number of scars was inversely related to gestational age and directly related to the duration of intensive care. Eleven children had cosmetically or functionally significant lesions caused by chest drain insertion, extravasation of intravenous fluid or skin stripping by adhesive tape. To reduce the frequency and severity of skin damage, neonatal staff need to be aware that many routine procedures may lead to long term scarring. In particular, more careful wound closure after chest drain removal is needed.