Gluteoperineal gangrene and sciatic nerve palsy after umbilical vessel injection.

Abstract

Thirteen patients with gluteoperineal necrosis of the skin and subcutaneous tissue without muscle involvement associated with palsy of the peroneal branch of the sciatic nerve were examined at the authors' institution. This syndrome was a complication after umbilical vessel catheterization for injection of medications mainly for respiratory distress and apnea. Skin and subcutaneous damaged tissues required debridement without sedation or anesthesia. Local antibiotic application and ultraviolet rays helped heal the lesions, leaving a star-like scar that did not cause cosmetic disfigurement or fistulae formation. For the residual peroneal nerve palsy with involvement of peroneal, toe extensor, and anterior tibialis musculature, the therapeutic approach initially consisted of physical therapy to the involved muscles of the foot. Surgery was required only to correct the deformity of the foot secondary to muscular deficits. In this series, the final results of the muscles involved secondary to nerve palsy were good in 4 patients, fair in 6, and poor in 3. No excellent result was noted.