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Evaluation of COVID-19 Prone-Induced Facial Pressure Sore Development and Rate of Operative Intervention
Danielle M. Khalilzadeh MS, Garrett V. Brittain MS, Spencer R. Anderson MD, Ron M. Johnson MD
Wright State University Boonshoft School of Medicine
2023-02-10
Presenter: Danielle Khalilzadeh
Affidavit:
This material has not been published anywhere or presented previously. The work on this project represents the original work of the resident/medical students with the conceptualization from the Program Director.
Director Name: Dr. R. Michael Johnson
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Hospitalized COVID-19 patients have a 61% chance of developing acute respiratory distress syndrome (ARDS). Per National Institute of Health, extended prone positioning is advantageous for patients with moderate-to-severe ARDS requiring mechanical ventilation. [1] Despite therapeutic benefit, over 45% of prone positioned COVID-19 patients experience facial pressure ulcers (FPU) as a complication [2,3]. To better understand the incidence and management of FPU in the COVID-19 population our study aims to identify best practices of FPU management, analyze the incidence of COVID-19 patients developing FPU secondary to proning techniques, and determine rate of survival and surgical intervention in managing FPU.
As a single-institution retrospective case-controlled study, 28 COVID-19 patients and 29 non-COVID-19 patients were randomly selected from electronic health record data and partitioned into two groups. Data variables such as total time spent prone, turning protocol, incidence of pressure sore development, pressure sore grade, and overall mortality were collected. Exhaustive data analysis to be completed by a biostatistician. At the time of submission, comprehensive data analysis is ongoing. Preliminary outcomes indicate COVID-19 patients on average develop 2.17 FPUs compared to 1.53 FPUs in the non-COVID-19 cohort (p=0.037). Additionally, COVID-19 patients with PTU were more likely to require surgical intervention, heal with deformities, or be complicated by death compared to non-COVID-19 patients with PTU (p=0.0045). We hypothesize COVID-19 patients have both a greater incidence and severity of FPU. Thus patients will require earlier discussion regarding plastic surgery involvement when facilitating a long-term plan of care.
