Harris Ann H, Coker Kara L, Smith Carla Gianoli, Uitvlugt Neal, Doctor Benedict
Spectrum Health, Grand Rapids, MI, USA.
Adv Neonatal Care. 2003 Oct;3(5):220-9.
This case report describes a 4350-gram male infant of 38 weeks gestation who was placed on extracorporeal life support. On day 4 of life, a large bilateral ecchymotic area involving the scapula and extending to the mid sacral-lumbar-thoracic area was noted, placing the infant at significant risk for pressure ulcer formation. The infant's initial presentation, evaluation, treatment, and response to therapy are discussed. A review of the anatomy and physiology of neonatal skin and the etiology of pressure ulcers is described. The incidence and staging of pressure ulcers is outlined, and high-risk infants and skin zones are identified. Skin care challenges in the patient on extracorporeal life support (ECLS) are outlined, and strategies to assess and treat affected areas are offered. The use of a novel mattress surface for global pressure reduction in the infant undergoing ECLS therapy is discussed.
本病例报告描述了一名孕38周、体重4350克的男婴，该婴儿接受了体外生命支持。出生后第4天，发现双侧肩胛区有一大片瘀斑，延伸至骶腰胸中部区域，这使婴儿有形成压疮的重大风险。文中讨论了该婴儿的初始表现、评估、治疗及对治疗的反应。描述了新生儿皮肤的解剖学和生理学以及压疮的病因。概述了压疮的发生率和分期，并确定了高危婴儿和皮肤区域。概述了体外生命支持（ECLS）患者的皮肤护理挑战，并提供了评估和治疗受影响区域的策略。讨论了在接受ECLS治疗的婴儿中使用新型床垫表面以全面减轻压力的情况。
