Facial pressure ulcers in COVID-19 patients undergoing prone positioning: How to prevent an underestimated epidemic?

Perrillat, Ambre; Foletti, J.M.; Lacagne, Anne-Sophie; Guyot, Laurent; Graillon, N.

doi:10.1016/j.jormas.2020.06.008

Cited by 65 publications

(94 citation statements)

References 8 publications

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“…There were 4 studies [ 12 , [24] , [25] , [26] ] (3 case reports and 1 case-control study) identified. It was ascertained that the main sites of pressure injuries were on the forehead, chin, cheeks, lips and chest ( Fig.…”

Section: Resultsmentioning

confidence: 99%

COVID-19 related pressure injuries in patients and personnel: A systematic review

Feng

et al. 2021

Journal of Tissue Viability

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Background Coronavirus disease 2019 (COVID-19) is causing a rapid and tragic health emergency worldwide. Because of the particularity of COVID-19, people are at a high risk of pressure injuries during the prevention and treatment process of COVID-19. Objectives This systematic review aimed to summarize the pressure injuries caused by COVID-19 and the corresponding preventive measures and treatments. Methods This systematic review was according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Web of science and CNKI (Chinese) were searched for studies on pressure injuries caused by COVID-19 published up to August 4, 2020. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the CARE guidelines. Results The data were extracted from 16 studies involving 7,696 participants in 7 countries. All studies were published in 2020. There are two main types of pressure injuries caused by the COVID-19: 1) Pressure injuries that caused by protective equipment (masks, goggles and face shield, etc.) in the prevention process; 2) pressure injuries caused by prolonged prone position in the therapy process. Conclusions In this systematic review, the included studies showed that wearing protective equipment for a long time and long-term prone positioning with mechanical ventilation will cause pressure injuries in the oppressed area. Foam dressing may need to be prioritized in the prevention of medical device related pressure injuries. The prevention of pressure injuries should be our particular attention in the course of clinical treatment and nursing.

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Section: Resultsmentioning

confidence: 99%

COVID-19 related pressure injuries in patients and personnel: A systematic review

Feng

et al. 2021

Journal of Tissue Viability

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“…In a short period of time since the recent COVID-19 outbreak, there have been a multitude of non-pulmonary complications reported. Perrillat et al [10] recently published their experience of two patients with mainly cheek ulcers after prolong intubation and prone positioning and highlighted the issue of facial ulcers in patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Medical device related pressure ulcer of the lip in a patient with COVID-19: Case report and review of the literature

Siotos

Bonett

Hansdorfer

et al. 2021

Journal of Stomatology, Oral and Maxillofacial Surgery

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Pressure ulcers of the lip constitute a rare entity faced by plastic surgeons and there is a relatively paucity of data regarding optimal management. In this study we present one case of upper lip pressure ulcer related to prone intubation for respiratory distress due to SARS-CoV-2 infection, treated with surgical excision and reconstruction. We also performed a review of the literature to identify other studies on pressure lip ulcers. Six studies were considered relevant. Conservative management constitutes the most common method of treatment; however, little is known about the aesthetic, and functional morbidity related to either surgical or non-surgical treatments.

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“…The checklist developed had patient preparation activities for prone position as an initial step (24) . As it was aimed at patients with COVID-19, the first action described was the complete dressing with relevant personal protective equipment (PPE) (3)(4) , followed by the assessment of the entire ventral region of the body, correct skin protection with multilayer silicone foam devices, removal of electrodes from the anterior region of the chest and positioning on the upper limbs, adequacy of cushions in the anterior region of the scapular line and pubic symphysis (25)(26)(27) .…”

Section: Study Protocolmentioning

confidence: 99%

“…From the second to the sixth step of the checklist, actions were included that must be performed immediately after positioning in prone position and at each rotation of the upper limb positioning. The second step, related to head care, begins with the bed positioning in reverse Trendelenburg at 30º (26) , in addition to lateralization, rotation of the head position on a cushion to the side of the upper limb that is elevated (24,(29)(30) . Other procedures present in this step are eye care (30) , in addition to the precautions for fixing the orotracheal cannula and enteric tubes, which must be centralized in the oral cavity (27,(30)(31)(32)(33) .…”

Section: Study Protocolmentioning

confidence: 99%

“…Positioning the bed in reverse Trendelenburg at 30º reduces the risk of facial edema and bronchoaspiration (26) , while lateralization and rotation of the head position avoids injuries in the auricular pavilion and in the lateral region of the face (24,(29)(30) . Eye care is necessary due to the potential increase in orbital pressure secondary to gravitational effects on prone position (30) .…”

Section: Study Protocolmentioning

confidence: 99%

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COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention

et al. 2021

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Objective: to perform the content and face validation of a checklist and a banner on pressure injury prevention in patients in prone position. Method: this is a methodological study of content and face validation with 26 nurses with specialization. Professionals assessed the checklist and the banner in relation to clarity, theoretical relevance, practical relevance, relation of the figures to the text and font size. The Content Validity Index was calculated for each item, considering one with a value equal to or greater than 0.8 as valid. Results: all the actions described in the checklist and in the banner had a Content Validity Index greater than 0.80, with standardization of verbal time and esthetic adjustments in the banner’s layout, as suggested. Conclusions: the checklist and the banner were validated and can be used in clinical practice to facilitate pressure injury preventions in patients in prone position.

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Facial pressure ulcers in COVID-19 patients undergoing prone positioning: How to prevent an underestimated epidemic?

Cited by 65 publications

References 8 publications

COVID-19 related pressure injuries in patients and personnel: A systematic review

COVID-19 related pressure injuries in patients and personnel: A systematic review

Medical device related pressure ulcer of the lip in a patient with COVID-19: Case report and review of the literature

COVID-19 patients in prone position: validation of instructional materials for pressure injury prevention

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