Recent publication about "HA-based products in Covid-19 patient"
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 year-old woman with the aim to describe the high-complexity management of COVID 19 in which healthcare professionals across the world are still involved.
“With regard to radiological examinations, a chest CT showed peripheral consolidations and ground-glass opacities in both lungs. The SARS-CoV-2 positive nasopharyngeal swab confirmed the suspected diagnosis. The patient was promptly intubated and transferred to a single room of the Intensive Care Unit of our hospital; ventilation was applied in a prone position. After 15 days of intensive care, a plastic surgery evaluation was requested for multiple facial skin lesions. We observed pressure ulcers and skin lesions due to maceration involving the lips, chin, perioral aerea, both cheeks, left zygomatic region, and superior and inferior left eyelids (►Fig. 1).
The patient was evaluated by using all the required droplet and contact precautions. The sequence for putting on and taking off of personal protective equipment (PPE) was respected. Some pictures of the clinical case were taken by using a camera previously covered with adhesive film.
As far as the dressing was concerned, we suggested the application of topical 1% Silver Sulfadiazine (Sofargen-Sofar), covering the wounds with gauzes impregnated with 0.2% Hyaluronic Acid And Sodium Salt (Connettivina-Fidia Farmaceutici s.p.a) and sterile gauzes. On the necrotic tissue on the eyelids and left zygomatic area, our dressing prescription was hyaluronic acid sodium salt collagenase ointment (Bionect Start-Fidia Farmaceutici s.p.a) twice per day. One week after the first plastic surgery evaluation, the patient clinical conditions worsened and a tracheostomy was performed. However, skin lesions improved”