Preventing Facial Pressure Ulcers in Acute Respiratory Distress Syndrome (ARDS)

Kim, Ruth S; Mullins, Kimberly

doi:10.1097/won.0000000000000247

Cited by 45 publications

(48 citation statements)

References 4 publications

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“…We recommend using a specific softer prone -positioning head cushion, with space for the breathing tube, and a better distribution of pressure points on the whole face or silicone gels or silicone foam dressings [9] (Fig. 3).…”

Section: Preventionmentioning

confidence: 99%

“…Head position should be changed 2 or 3 times during a prone position session and the position of the breathing tube should be changed between each prone position session [5]. The circumferential fixation should be protected with gauzes or replaced by a specific endotracheal tube holder endowed with a silicon shield in contact with the cheek and the labial commissure [9]. In case 1 incomplete eyelid closure led to the occurrence of a corneal ulcer.…”

Section: Preventionmentioning

confidence: 99%

“…Prone position allows for dorsal lung regions recruitment, endexpiratory lung volume increase, and alveolar shunt decrease [3]. As the prone position must be maintained for 10 to 12 h to be effective [3], it may result in prolonged pressure points on the face leading to potential ischemic lesions [4]. Facial pressure ulcers resulting from prone positioning have already been described for treatment of ARDS of various origins before the COVID-19 pandemic [5].…”

Section: Introductionmentioning

confidence: 99%

“…Facial pressure ulcers resulting from prone positioning have already been described for treatment of ARDS of various origins before the COVID-19 pandemic [5]. These facial ulcers occur mostly at the level of the bony structures including: the forehead, the cheekbone and the chin [4].…”

Section: Introductionmentioning

confidence: 99%

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

Perrillat

Foletti

Lacagne

et al. 2020

Journal of Stomatology, Oral and Maxillofacial Surgery

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Section: Preventionmentioning

confidence: 99%

Section: Preventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Perrillat

Foletti

Lacagne

et al. 2020

Journal of Stomatology, Oral and Maxillofacial Surgery

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“…As suggested in the literature, a thin silicone foam dressing can represent a valid precaution approach. 4 The frequent mobilization of the patients is mandatory to reduce the risk of facial pressure ulcers and avoid any cicatricial or permanent discromic effect. In this case, the suggested topical treatment promoted wound healing.…”

Section: Discussionmentioning

confidence: 99%

Facial Pressure Ulcers in a COVID-19 50-year-old Female Intubated Patient

Zingarelli

Ghiglione

Pesce

et al. 2020

Indian J Plast Surg

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In case of severe acute respiratory distress syndrome (ARDS), as in coronavirus disease 2019 (COVID-19) affected patients, the invasive ventilation in prone position can improve the prognosis, albeit with an increased risk of facial pressure ulcers. In this report, we will relate a case of facial pressure ulcers in a SARS-CoV-2 positive 50 yearold woman with the aim to describe the high-complexity management of COVID 19 in which healthcare professionals across the world are still involved. AbstractKeywords ► SARS-CoV-2 ► Covid-19 ► facial pressure ulcers

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Facial Pressure Injuries from Prone Positioning in the COVID‐19 Era

et al. 2021

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Objective/Hypothesis This study aimed to determine the incidence of facial pressure injuries associated with prone positioning for COVID‐19 patients as well as to characterize the location of injuries and treatments provided. Methods This was a retrospective chart review of 263 COVID‐19 positive patients requiring intubation in the intensive care units at MedStar Georgetown University Hospital and MedStar Washington Hospital Center between March 1st and July 26th, 2020. Information regarding proning status, duration of proning, presence, or absence of facial pressure injuries and interventions were collected. Paired two‐tailed t‐test was used to evaluate differences between proned patients who developed pressure injuries with those who did not. Results Overall, 143 COVID‐19 positive patients required proning while intubated with the average duration of proning being 5.15 days. Of those proned, 68 (47.6%) developed a facial pressure injury. The most common site involved was the cheek with a total of 57 (84%) followed by ears (50%). The average duration of proning for patients who developed a pressure injury was significantly longer when compared to those who did not develop pressure injuries (6.79 days vs. 3.64 days, P < .001). Conclusions Facial pressure injuries occur with high incidence in patients with COVID‐19 who undergo prone positioning. Longer duration of proning appears to confer greater risk for developing these pressure injuries. Hence, improved preventative measures and early interventions are needed. Level of Evidence 4 Laryngoscope, 131:E2139–E2142, 2021

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Preventing Facial Pressure Ulcers in Acute Respiratory Distress Syndrome (ARDS)

Abstract: The use of thin soft silicone foam dressings may prevent the development of facial deep tissue injuries in patients receiving prolonged pronation therapy.

Cited by 45 publications

References 4 publications

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

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

Facial Pressure Ulcers in a COVID-19 50-year-old Female Intubated Patient

Facial Pressure Injuries from Prone Positioning in the COVID‐19 Era

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