Dec 11, 2014 - Perioperative care following complex laryngotracheal reconstruction in infants and children. Saudi Journal of Anesthesia 4:186-96. 7.
International Society for Pediatric Wound Care – 2nd International Meeting December 11th-12th, 2014
OCCIPITAL PRESSURE ULCER PREVENTION IN PICU: TWO CASES G. ANTONIELLI*RN, R. MAIALE*RN, G. CIPRANDI**MD
*R.N.,SKIN CARE TEAM , DEPT. ANESTHESIA AND INTENSIVE CARE,BAMBINO GESU’ CHILDREN’S HOSPITAL IRCCS, ROME, **MD, PHD, FEUPSA, PEDIATRIC SURGEON, THORACIC SURGEON, MICROVASCULAR SURGEON RESPONSIBLE FOR PRESSURE ULCER AND COMPLEX LESIONS PROJECT,UNIT OF PLASTIC AND MAXILLOFACIAL SURGERY DEPT OF SURGERY, BAMBINO GESU' CHILDREN'S HOSPITAL, IRCCS, ROME,
Where we started. In
period A, (29.11.2012-30.06.2013), six children had received a standardized preventive strategy after larynx surgery and two of them had developed Occipital Pressure Ulcers due to sedation, mechanical ventilation and immobilization up to 7 days. In period B, (01.07.2013-01.02.2014) a preventive strategy had took place in six children with the same clinical history, two of them were immobilized up to 7 days, but no one had developed Occipital Pressure Ulcers.
Who we present you • The first patient was a male, age 2 years and 10 months, weight of 13 kg,
with a Vacter Syndrome with stenosis of the region glottic, subglottic • The second patient was a Female patient two years and nine months; body
weight of 21 kg; with vocal cord paralysis after prolonged intubation at birth. In both of them and Analgesia, sedation and mechanical ventilation (VGRP
modality) were performed for 7 days. During this period, the children had remained in the supine position and
posture changes were not made because of the particular surgical technique.
What we did As soon as the patients had arrived in our Pediatric Intensive Care Unit a
semi-opened cell polyurethanic foam ( Ligasano Bianco®) was interposed between the head and the pillow normally used as a bedsores prevention up to weaning from mechanical ventilation and sedation. At the first mobilization was carried out both assessment of the occipital
region and general assessment of the patient's skin.
What we did
Patient 1
Patient 2
Summary
Summary2 Occipital Pressure Ulcer Prevention 6
6
2 0 period A : Not ligasano apllied
Period B: Ligasano preventive treatment
Conclusions The sample can not be considered representative, but the
work in intended to draws attention to a problem that is not always managed properly The use of preventive strategy in ventilated and immobilized
patient for over 96 hours, have take place as soon as possible The use of the most correct dressing or overlay device has to
be considered carefully. Further researches, focused on the prevention of occipital skin
lesions, in the pediatric population, are needed and be shared.
EBP? It will never work.
THANKS!
Reference/Bibliography: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.
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Acknowledgment: all the nursing staff of the Pediatric Intensive Care Unit of Children's Hospital Bambino Gesù, Palidoro.
