An 8-day-old female neonate, preterm at 36 weeks, high birth weight (3,600 g), suffering from peripartum asphyxia with moderate-severe neonatal encephalopathy. Due to peripartum asphyxia, she was treated at the regional hospital of origin with systemic hypothermia using the CritiCool® system (MTRE, Mennen Medical Corp, USA). Eight days after admission, he was transferred to the Paediatric Monitoring Unit of the Hospital 12 de Octubre. During his stay in this unit he was referred to the Plastic Surgery Department for an early onset dorsal skin lesion. During the assessment we observed a tumour on the back, in the midline, measuring 11x13x4 cm, partially fluctuant, with a central blackish eschar measuring approximately 5 cm in diameter.
A soft tissue ultrasound was requested to try to establish the diagnosis, which revealed liquefactive fat necrosis. We performed 2 punctures to evacuate the contents without success, so we decided to perform surgical debridement and application of vacuum therapy (Renasys®, Smith&Nephew®, London, UK), on the 11th day of admission. The therapy was set at a pressure of 100 mmHg, with continuous cycles and dressing changes every 72 hours.

The patient underwent surgery after 21 days of treatment with vacuum therapy. At the time of surgery, the wound had a good appearance, with a background of granulation tissue and no exudate. Tissue advancement was performed, leaving a central cruciate area of 1 cm2. The patient was admitted to the Neonatology Department of our hospital and was finally discharged 5 days postoperatively, at the age of 45 days.
After 8 months of evolution, the patient has a stable wound, without pain, which allows her to lead a normal life, scoring 2 points on the Vancouver Scar Scale.