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AI-Generated response:

What are strategies to avoid pressure ulcers related to respiratory devices?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

To avoid pressure ulcers related to respiratory devices, use hydrogel-based dressings at the mask-skin interface and ensure proper positioning and frequent repositioning of the patient.

  • Employ hydrogel-based dressings to reduce tissue loading and protect against pressure ulcers at high-risk facial areas such as the nasal bridge and cheeks.[1]

  • Regularly adjust the position of the respiratory device to minimize sustained pressure on any one area.[1]

  • Implement frequent patient repositioning to alleviate pressure and enhance blood circulation, which is crucial in preventing pressure ulcers.[2]

  • Use pressure-reducing beds or advanced static mattresses to support proper patient positioning and reduce the risk of pressure ulcers.[2]

  • Monitor the skin regularly for any signs of pressure damage or ulceration, especially in areas under the device.[1-2]

Additional info

The strategies mentioned are critical in managing patients who require respiratory support, particularly those using devices like CPAP masks. Hydrogel-based dressings have been specifically shown to reduce the risk of device-related pressure ulcers by minimizing the compressive forces exerted on the skin. This is particularly important in areas like the nasal bridge and cheeks, where the risk of injury is higher due to the anatomy and the pressure exerted by masks. Regular repositioning and the use of specialized mattresses help distribute weight and pressure more evenly, which is essential in preventing the development of pressure ulcers. Regular skin assessments allow for early detection and management of potential pressure ulcers, ensuring timely intervention and reducing the risk of complications. These measures are not only preventive but also enhance the overall comfort and care of patients requiring mechanical ventilation or respiratory support.

References

Reference 1

1.

Grigatti A, Gefen A. International Wound Journal. 2022;19(5):1051-1063. doi:10.1111/iwj.13701.

Publish date: August 1, 2022.

Continuous positive airway pressure masks for breathing assistance are used widely during the coronavirus pandemic. Nonetheless, these masks endanger the viability of facial tissues even after a few hours because of the sustained tissue deformations and extreme microclimate conditions. The risk of developing such device-related pressure ulcers/injuries can be reduced through suitable cushioning materials at the mask-skin interface, to alleviate localised contact forces. Here, we determined the facial tissue loading state under an oral-nasal mask while using hydrogel-based dressing cuts (Paul Hartmann AG, Heidenheim, Germany) for prophylaxis, which is a new concept in prevention of device-related injuries. For this purpose, we measured the compressive mask-skin contact forces at the nasal bridge, cheeks, and chin with vs without these dressing cuts and fed these data to a finite element, adult head model. Model variants were developed to compare strain energy densities and effective stresses in skin and through the facial tissue depth, with vs without the dressing cuts. We found that the dry (new) dressing cuts reduced tissue exposures to loads (above the median loading level) by at least 30% at the nasal bridge and by up to 99% at the cheeks, across the tissue depth. These dressing cuts were further able to maintain at least 65% and 89% of their protective capacity under moisture at the nasal bridge and cheeks, respectively. The hydrogel-based dressings demonstrated protective efficacy at all the tested facial sites but performed the best at the nasal bridge and cheeks, which are at the greatest injury risk.

Reference 2

2.

Walston, Jeremy D. (2024). In Goldman-Cecil Medicine (pp. 120). DOI: 10.1016/B978-0-323-93038-3.00024-1

Safe positioning, regular turning, avoidance of direct pressure, pressure-reducing beds, and advanced static mattresses or advanced static overlays can reduce the incidence of pressure sores. Alternating air mattresses or overlays are not recommended.Pressure sores should be photographed to establish a baseline. The wound should be freed of any pressure to prevent additional pressure ulcers. Wet-to-dry dressings are a mainstay, and semiocclusive and occlusive dressings also can be helpful. Protein or amino acid supplementation enriched with zinc and antioxidants,hydrocolloid or foam dressings, and adjunctive electrical stimulation may be useful. Surgical or chemical débridement is often required. Topical or systemic antibiotics (Chapter 261) may be needed. Pressure ulcers usually heal within 6 months, but surgical repair is sometimes required.

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