Management of skin damage of health workers’ face: the role of plastic surgery in the time of Pandemic: Management of skin damages in Covid-19 pandemic

Management of skin damage of health workers’ face: the role of plastic surgery in the time of Pandemic

Management of skin damages in Covid-19 pandemic

Authors

  • Roberto Cuomo University of Siena
  • Francesco Ruben Giardino 1- Department of Medicine, Surgery and Neuroscience – Plastic and Reconstructive Surgery Unit – University of Siena – Italy
  • Mirco Pozzi 1- Department of Medicine, Surgery and Neuroscience – Plastic and Reconstructive Surgery Unit – University of Siena – Italy
  • Giuseppe Nisi 1- Department of Medicine, Surgery and Neuroscience – Plastic and Reconstructive Surgery Unit – University of Siena – Italy
  • Andrea Sisti Visiting Researcher - Department of Plastic Surgery, Cleveland Clinic Ohio, USA
  • Jingjian Han Jining First People’s Hospital - Jining Medical University – Jining city – People’s Republic of China
  • Angelo Nuzzo COVID Department – Intensive Care Unit – University of Siena – Italy
  • Alessia Muratori COVID Department – Intensive Care Unit – University of Siena – Italy
  • Emanuele Cigna Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy
  • Luigi Losco Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa; Pisa, Italy
  • Luca Grimaldi Department of Medicine, Surgery and Neuroscience – Plastic and Reconstructive Surgery Unit – University of Siena – Italy

Keywords:

Covid-19; nasal bridge ulcer; wound care; wounds

Abstract

Background

The Sars-Cov-2 virus is characterized by a being highly contagiousness, and this is the reason why massive use of personal protective equipment is required by medical and paramedical staff of the COVID-19 dedicated departments.

The aim of this manuscript is to describe and share our experience in the prevention and treatment of the personal protective equipment related pressure sores and other skin alterations in the medical and paramedical staff.

Materials and methods

All healthcare workers with PPE-related skin damages were registered at time 0.

Age, sex, profession, type of skin damage, diseases and possible drugs were registered.

Results

Two strategies were emplyed: the first strategy was to immediately treat the skin and the second one was to prevent pressure wounds formation both in already affected healthcare workers and the recurrence in healed staff.

Three weeks after the two strategies were used, the incidence rate PPE-related skin damage was reduced in a statistically significant way.

Conclusions

Proper management helps in reducing the incidence of pressure ulcers related to  personal protective devices in CoVid-19 Units. Skin prevention and hydration, have been obtained achieved by using products applied at home, autonomously.

References

Delgado D, Wyss Quintana F, Perez G, et al. Personal Safety during the COVID-19 Pandemic: Realities and Perspectives of Healthcare Workers in Latin America. Int J Environ Res Public Health.2020;17.

Bouaziz JD, Duong T, Jachiet M, et al. Vascular skin symptoms in COVID-19: a french observational study. J Eur Acad Dermatol Venereol.2020.

Zhang Y, Cao W, Xiao M, et al. [Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia]. Zhonghua Xue Ye Xue Za Zhi.2020;41:E006.

Yin Z. Covid-19: Countermeasure for N95 mask-induced pressure sore. J Eur Acad Dermatol Venereol.2020.

Mascarello M, Papa G, Arnez ZM, Luzzati R. Acute necrotizing pancreatitis related to tigecycline. J Antimicrob Chemother.2012;67:1296-7.

Posthauer ME, Banks M, Dorner B, Schols JM. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper. Adv Skin Wound Care.2015;28:175-88; quiz 89-90.

Callaghan S, Trapp M. Evaluating two dressings for the prevention of nasal bridge pressure sores. Prof Nurse.1998;13:361-4.

Holanda MA, Reis RC, Winkeler GF, et al. Influence of total face, facial and nasal masks on short-term adverse effects during noninvasive ventilation. J Bras Pneumol.2009;35:164-73.

Weng MH. The effect of protective treatment in reducing pressure ulcers for non-invasive ventilation patients. Intensive Crit Care Nurs.2008;24:295-9.

Yamaguti WP, Moderno EV, Yamashita SY, et al. Treatment-related risk factors for development of skin breakdown in subjects with acute respiratory failure undergoing noninvasive ventilation or CPAP. Respir Care.2014;59:1530-6.

Losco L, Lo Torto F, Maruccia M, et al. Modified single pedicle reverse adipofascial flap for fingertip reconstruction. Microsurgery.2019;39:221-7.

Marcasciano M, Kaciulyte J, Mori FLR, et al. Breast surgeons updating on the thresholds of COVID-19 era: results of a multicenter collaborative study evaluating the role of online videos and multimedia sources on breast surgeons education and training. European review for medical and pharmacological sciences.2020;24:7845-54.

Bishopp A, Oakes A, Antoine-Pitterson P, et al. The Preventative Effect of Hydrocolloid Dressings on Nasal Bridge Pressure Ulceration in Acute Non-Invasive Ventilation. Ulster Med J.2019;88:17-20.

Gay PC. Complications of noninvasive ventilation in acute care. Respir Care.2009;54:246-57; discussion 57-8.

Ramella V, Papa G, Bottosso S, Cazzato V, Arnez ZM. Microsurgical reconstruction in the time of COVID-19. Microsurgery.2020.

Papa G, Pangos M, Renzi N, et al. Five years of experience using a dermal substitute: indications, histologic studies, and first results using a new single-layer tool. Dermatol Surg.2011;37:1631-7.

Arnez ZM, Papa G, Ramella V, et al. Limb and Flap Salvage in Gustilo IIIC Injuries Treated by Vascular Repair and Emergency Free Flap Transfer. J Reconstr Microsurg.2017;33:S03-S7.

Mancini S, Cuomo R, Poggialini M, D'Aniello C, Botta G. Autolytic debridement and management of bacterial load with an occlusive hydroactive deressing impregnated with polyhexamethylene biguanide. Acta bio-medica : Atenei Parmensis.2018;88:409-13.

Sisti A, Cuomo R, Zerini I, et al. Complications Associated With Medial Thigh Lift: A Comprehensive Literature Review. J Cutan Aesthet Surg.2015;8:191-7.

D'Aniello C, Cuomo R, Grimaldi L, et al. Superior Pedicle Mammaplasty without Parenchymal Incisions after Massive Weight Loss. Journal of investigative surgery : the official journal of the Academy of Surgical Research.2017;30:410-20.

Acorda DE. Nursing and Respiratory Collaboration Prevents BiPAP-Related Pressure Ulcers. J Pediatr Nurs.2015;30:620-3.

Cooper L, Vellodi C, Stansby G, Avital L. The prevention and management of pressure ulcers: summary of updated NICE guidance. J Wound Care.2015;24:179-81, 84.

Cooper P, Gray D. Best practice statement of the prevention of pressure ulcers. Br J Nurs.2002;11:S38, S40, S2 passim.

Jones DJ, Braid GM, Wedzicha JA. Nasal masks for domiciliary positive pressure ventilation: patient usage and complications. Thorax.1994;49:811-2.

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Published

12-05-2021

Issue

Section

ORIGINAL INVESTIGATIONS/COMMENTARIES - SPECIAL COVID19

How to Cite

1.
Cuomo R, Giardino FR, Pozzi M, et al. Management of skin damage of health workers’ face: the role of plastic surgery in the time of Pandemic: Management of skin damages in Covid-19 pandemic. Acta Biomed. 2021;92(2):e2021185. doi:10.23750/abm.v92i2.11006