title: [Iatrogenic skin lesions: a prospective study in premature infants born at less than 33 weeks of amenorrhea at Besançon university hospital].
abstract: BACKGROUND
  Advances in neonatology have markedly improved prognosis for premature babies in recent years. However, they have also entailed the need for recourse to considerable intensive care involving potentially iatrogenic diagnostic and therapeutic acts. Among the resulting iatrogenic events, cutaneous lesions are the most frequent but have been the subject of very few studies. Our own study thus aimed to assess the rate of iatrogenic cutaneous events in premature infants born at less than 33 weeks of amenorrhea and hospitalised at Besançon university hospital and to identify the factors associated with the occurrence of these events.
  
  
  METHODS
  This was a prospective study carried out in the department of paediatric intensive care and neonatology at Besançon university hospital between May 2011 and April 2012. All babies born before 33 weeks of amenorrhea hospitalised over this period were included. An iatrogenic event was defined as "an adverse event related to a medical procedure". Iatrogenic cutaneous events were reported to the dermatologist by medical and paramedical staff.
  
  
  RESULTS
  One hundred and thirthteen newborn babies were included during the study period. Twenty-six iatrogenic cutaneous events were recorded in 19 infants, representing 16.8% of the population involved: nine were associated with ventilation techniques, six with the use of intravenous catheters, five with electrodes, two involved pressure sores, two were linked to the birth, one to disinfectants and one to dressings. The main risk factor was low birth weight (P=0.016). High prematurity and the duration of ventilation increased the risk, although not significantly. The death rate was higher in children with iatrogenic events but the difference was not significant. The duration of hospitalisation was unaffected by the presence or absence of an iatrogenic event.
  
  
  CONCLUSIONS
  The frequency of iatrogenic cutaneous events is high in hospital departments in charge of very premature infants. Awareness by the medical and paramedical staff of the frequency of such iatrogenic events should improve the quality of care.
authors.affiliation: Service de dermatologie, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France. Electronic address: rochebl@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Roche-Kubler
authors.affiliation: Service de dermatologie, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Puzenat
authors.affiliation: Département d'information médicale, CHU de Besançon, 25030 Besançon cedex, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Mariet
authors.affiliation: Service de réanimation pédiatrique, CHU de Besançon, 25030 Besançon cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Thiriez
authors.affiliation: Service de dermatologie, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; EA3181, SFR FED 4234 IBCT, université de Franche-Comté, 25030 Besançon cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Aubin
authors.affiliation: Service de dermatologie, CHU de Besançon, 3, boulevard Alexandre-Fleming, 25030 Besançon cedex, France; Inserm U1098, SFR FED 4234 IBCT, université de Franche-Comté, 25030 Besançon cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Humbert
mesh_terms: D001458:Bandages / Q000009:adverse effects; D002405:Catheterization, Central Venous / Q000009:adverse effects; D004202:Disinfectants / Q000009:adverse effects; D004566:Electrodes / Q000009:adverse effects; D005113:Extraction, Obstetrical / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D007231:Infant, Newborn; D007234:Infant, Premature; D015278:Intensive Care Units, Pediatric; D008297:Male; D008991:Monitoring, Physiologic / Q000009:adverse effects / Q000295:instrumentation; D003668:Pressure Ulcer / Q000209:etiology; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects; D012871:Skin Diseases / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D004202:Disinfectants
keywords: Iatrogenesis; Iatrogénie; Monitoring; Neonatology; Néonatologie; Prematurity; Prématurité; Skin care; Soins de peau