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Experts have expressed concerns that pressure injuries, also known as bedsores, have risen with the spike in hospitalizations during the Covid-19 pandemic. As such, according to a new report in USA Today, “hospitals are putting extra focus” on preventing bedsores, which more than 2.5 million people suffer from each year, according to a the National Pressure Injury Advisory Panel estimate, and which kill more than 60,000 people annually.
Pressure injuries involve “localized damage to the skin or underlying soft tissue,” the report states. They often occur over “a bony area or from a medical device,” when the area experiences either “intense” or sustained pressure, or both. A pressure injury may simply involve a light abrasion of the skin, or an open wound.
The NPIAP’s president-elect, William Padula, who is also a professor at the University of Southern California, told USA today that residents can suffer bedsores “within hours” of being placed on a ventilator in a hospital’s intensive care unit. Martine Sanone, a professor at the Icahn School of Medicine, said “The skin is the largest organ system… However, when we think of critical illness, we forget about that first barrier.”
As other wound specialized explained to USA Today, coronavirus patients are at high risk of pressure injuries because when they’re sedated, they “are usually placed in the prone position to assist with breathing – on their belly instead of their back.” When they’re on their bellies, the nurses taking care of them must look out for injuries on their faces, shoulders, knees, and ears, the report states. Because some areas swell quickly, nurses must “consistently check on patients to readjust body position or medical equipment.”
As the report observes, the very conditions that leave patients at high risk of severe Covid-19 cases, like obesity and old age-related conditions, make them susceptible to pressure injuries. ““Skin failure is when you start getting wounds that you can’t protect against,” one wound specialist told USA Today. ““It’s when the skin doesn’t have the resilience anymore to take any pressure, you start getting pressure injuries from the least little insults.”
The wound specialists recommend seeking to prevent bedsores with the use of foam dressing to relieve pressure on areas that are most likely to be affected. Still, a study into “hospital-acquired pressure injuries” led by a group called CTH found that the causes vary by institution, with some having injuries resulting from medical devices while others had injuries resulting from “a lack of assessment and documentation,” or other factors. An official at CTH concluded, “there isn’t a silver bullet or magic bullet to solve the issue at hand because they’re really complex.”
More information on pressure injuries, also known as pressure ulcers or bedsores, during the Covid-19 pandemic is available via USA Today’s report here.
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