Skin and Mucosal Damage in Patients Diagnosed With COVID-19: A Case Report.
Identifieur interne : 000003 ( Main/Exploration ); précédent : 000002; suivant : 000004Skin and Mucosal Damage in Patients Diagnosed With COVID-19: A Case Report.
Auteurs : Charleen Singh [Jordanie] ; Jafar Tay ; Noordeen ShoqiratSource :
- Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society [ 1528-3976 ]
Descripteurs français
- KwdFr :
- Adulte (MeSH), Betacoronavirus (MeSH), Escarre (anatomopathologie), Escarre (prévention et contrôle), Escarre (étiologie), Femelle (MeSH), Humains (MeSH), Infections à coronavirus (complications), Infections à coronavirus (thérapie), Muqueuse (traumatismes), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (thérapie), Sujet âgé (MeSH), Ventilation artificielle (effets indésirables), Ventilation artificielle (instrumentation), Équipement et fournitures (effets indésirables).
- MESH :
- anatomopathologie : Escarre.
- effets indésirables : Infections à coronavirus, Pneumopathie virale, Ventilation artificielle, Équipement et fournitures.
- prévention et contrôle : Escarre.
- thérapie : Infections à coronavirus, Pneumopathie virale.
- traumatismes : Muqueuse, Ventilation artificielle.
- étiologie : Escarre.
- Adulte, Betacoronavirus, Femelle, Humains, Mâle, Pandémies, Sujet âgé.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Betacoronavirus (MeSH), Coronavirus Infections (complications), Coronavirus Infections (therapy), Equipment and Supplies (adverse effects), Female (MeSH), Humans (MeSH), Male (MeSH), Mucous Membrane (injuries), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (therapy), Pressure Ulcer (etiology), Pressure Ulcer (pathology), Pressure Ulcer (prevention & control), Respiration, Artificial (adverse effects), Respiration, Artificial (instrumentation).
- MESH :
- adverse effects : Equipment and Supplies, Respiration, Artificial.
- complications : Coronavirus Infections, Pneumonia, Viral.
- etiology : Pressure Ulcer.
- injuries : Mucous Membrane.
- instrumentation : Respiration, Artificial.
- pathology : Pressure Ulcer.
- prevention & control : Pressure Ulcer.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- Adult, Aged, Betacoronavirus, Female, Humans, Male, Pandemics.
Abstract
Patients admitted to the intensive care unit (ICU) are at a high risk for developing pressure injuries. A patient requiring multiorgan support is at a higher risk for pressure injuries related to immobility, sedation, vasopressors, and hypoxia. To mitigate pressure injuries, our hospital utilizes a bundle approach to prevent skin injury. However, despite efforts to prevent pressure injuries, we found our patients in the ICU with the diagnosis of COVID-19 went on to develop significant pressure and mucosal injuries. This is a case report of 4 patients diagnosed with COVID-19 who developed significant skin and mucosal injuries during their ICU admissions in the month of March 2020. We found that patients developed skin conditions that were initially thought to be deep-tissue injuries (DTIs) early in the admission. The DTIs progressed over the course of the admission in the ICU and evolved to thick adherent eschar that appeared to be unstageable pressure injuries, which extended beyond the soft tissue directly over the bony prominence. We also found that skin damage to the mucosa of the nares, tongue, lips, and urethra presented first as inflammation and then progressed to thick eschar. Despite maximum pressure relief with the use of a pressure-relieving turn and position system, bordered foam dressings, fluidized positioners, specialty beds, and leadership support for twice-a-week skin checks, our patients diagnosed with COVID-19 developed extensive skin damage across the fleshy portion of the buttocks and on the mucosa of the nares, tongue, lips, and urethra during minimal exposure to pressure. Although the initial presentation of the skin damage appeared to be related to pressure, the extent of the skin damage suggests a vascular inflammatory process beyond skin damage related to pressure.
DOI: 10.1097/WON.0000000000000690
PubMed: 32868736
Affiliations:
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Noordeen Shoqirat, PhD, RN, Nursing Faculty, Mutah University, Karak, Jordan.</nlm:affiliation><country xml:lang="fr">Jordanie</country><wicri:regionArea>Charleen Singh, PhD, FNP-BC, CWOCN, Wound Care Services, Regional Medical Center, San Jose, California; University of California Davis Betty Irene Moore School of Nursing, Sacramento; and Santa Barbara Cottage Hospital, Santa Barbara, California. Jafar Tay, MD, Medical Director Vascular and Wound Care Services, Regional Medical Center San Jose, California. 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Jafar Tay, MD, Medical Director Vascular and Wound Care Services, Regional Medical Center San Jose, California. Noordeen Shoqirat, PhD, RN, Nursing Faculty, Mutah University, Karak, Jordan.</nlm:affiliation><country xml:lang="fr">Jordanie</country><wicri:regionArea>Charleen Singh, PhD, FNP-BC, CWOCN, Wound Care Services, Regional Medical Center, San Jose, California; University of California Davis Betty Irene Moore School of Nursing, Sacramento; and Santa Barbara Cottage Hospital, Santa Barbara, California. Jafar Tay, MD, Medical Director Vascular and Wound Care Services, Regional Medical Center San Jose, California. 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A patient requiring multiorgan support is at a higher risk for pressure injuries related to immobility, sedation, vasopressors, and hypoxia. To mitigate pressure injuries, our hospital utilizes a bundle approach to prevent skin injury. However, despite efforts to prevent pressure injuries, we found our patients in the ICU with the diagnosis of COVID-19 went on to develop significant pressure and mucosal injuries. This is a case report of 4 patients diagnosed with COVID-19 who developed significant skin and mucosal injuries during their ICU admissions in the month of March 2020. We found that patients developed skin conditions that were initially thought to be deep-tissue injuries (DTIs) early in the admission. The DTIs progressed over the course of the admission in the ICU and evolved to thick adherent eschar that appeared to be unstageable pressure injuries, which extended beyond the soft tissue directly over the bony prominence. We also found that skin damage to the mucosa of the nares, tongue, lips, and urethra presented first as inflammation and then progressed to thick eschar. Despite maximum pressure relief with the use of a pressure-relieving turn and position system, bordered foam dressings, fluidized positioners, specialty beds, and leadership support for twice-a-week skin checks, our patients diagnosed with COVID-19 developed extensive skin damage across the fleshy portion of the buttocks and on the mucosa of the nares, tongue, lips, and urethra during minimal exposure to pressure. Although the initial presentation of the skin damage appeared to be related to pressure, the extent of the skin damage suggests a vascular inflammatory process beyond skin damage related to pressure.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32868736</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>09</Day></DateCompleted><DateRevised><Year>2020</Year><Month>10</Month><Day>09</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1528-3976</ISSN><JournalIssue CitedMedium="Internet"><Volume>47</Volume><Issue>5</Issue><PubDate><MedlineDate>2020 Sep/Oct</MedlineDate></PubDate></JournalIssue><Title>Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society</Title><ISOAbbreviation>J Wound Ostomy Continence Nurs</ISOAbbreviation></Journal><ArticleTitle>Skin and Mucosal Damage in Patients Diagnosed With COVID-19: A Case Report.</ArticleTitle><Pagination><MedlinePgn>435-438</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1097/WON.0000000000000690</ELocationID><Abstract><AbstractText>Patients admitted to the intensive care unit (ICU) are at a high risk for developing pressure injuries. A patient requiring multiorgan support is at a higher risk for pressure injuries related to immobility, sedation, vasopressors, and hypoxia. To mitigate pressure injuries, our hospital utilizes a bundle approach to prevent skin injury. However, despite efforts to prevent pressure injuries, we found our patients in the ICU with the diagnosis of COVID-19 went on to develop significant pressure and mucosal injuries. This is a case report of 4 patients diagnosed with COVID-19 who developed significant skin and mucosal injuries during their ICU admissions in the month of March 2020. We found that patients developed skin conditions that were initially thought to be deep-tissue injuries (DTIs) early in the admission. The DTIs progressed over the course of the admission in the ICU and evolved to thick adherent eschar that appeared to be unstageable pressure injuries, which extended beyond the soft tissue directly over the bony prominence. We also found that skin damage to the mucosa of the nares, tongue, lips, and urethra presented first as inflammation and then progressed to thick eschar. Despite maximum pressure relief with the use of a pressure-relieving turn and position system, bordered foam dressings, fluidized positioners, specialty beds, and leadership support for twice-a-week skin checks, our patients diagnosed with COVID-19 developed extensive skin damage across the fleshy portion of the buttocks and on the mucosa of the nares, tongue, lips, and urethra during minimal exposure to pressure. Although the initial presentation of the skin damage appeared to be related to pressure, the extent of the skin damage suggests a vascular inflammatory process beyond skin damage related to pressure.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Charleen</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Charleen Singh, PhD, FNP-BC, CWOCN, Wound Care Services, Regional Medical Center, San Jose, California; University of California Davis Betty Irene Moore School of Nursing, Sacramento; and Santa Barbara Cottage Hospital, Santa Barbara, California. Jafar Tay, MD, Medical Director Vascular and Wound Care Services, Regional Medical Center San Jose, California. Noordeen Shoqirat, PhD, RN, Nursing Faculty, Mutah University, Karak, Jordan.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tay</LastName><ForeName>Jafar</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Shoqirat</LastName><ForeName>Noordeen</ForeName><Initials>N</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Wound Ostomy Continence Nurs</MedlineTA><NlmUniqueID>9435679</NlmUniqueID><ISSNLinking>1071-5754</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>N</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004864" MajorTopicYN="N">Equipment and Supplies</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009092" MajorTopicYN="N">Mucous Membrane</DescriptorName><QualifierName UI="Q000293" MajorTopicYN="Y">injuries</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003668" MajorTopicYN="N">Pressure Ulcer</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="N">Respiration, Artificial</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000295" MajorTopicYN="N">instrumentation</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32868736</ArticleId><ArticleId IdType="doi">10.1097/WON.0000000000000690</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Jordanie</li></country></list><tree><noCountry><name sortKey="Shoqirat, Noordeen" sort="Shoqirat, Noordeen" uniqKey="Shoqirat N" first="Noordeen" last="Shoqirat">Noordeen Shoqirat</name><name sortKey="Tay, Jafar" sort="Tay, Jafar" uniqKey="Tay J" first="Jafar" last="Tay">Jafar Tay</name></noCountry><country name="Jordanie"><noRegion><name sortKey="Singh, Charleen" sort="Singh, Charleen" uniqKey="Singh C" first="Charleen" last="Singh">Charleen Singh</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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