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一名患有败血症的早产新生儿暴发性紫癜皮肤病变的管理:病例报告

Management of purpura fulminans skin lesions in a premature neonate with sepsis: a case study.

作者信息

Pérez-Acevedo Gemma, Torra-Bou Joan Enric, Manzano-Canillas Maria Luisa, Bosch-Alcaraz Alejandro

机构信息

Nurse, Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Esplugues de Llobregat, Barcelona, Spain.

Nurse, Professor, University of Lleida, GRECS-IRB Lleida and TR2Lab-UVic-Central de Catalunya, Spain.

出版信息

J Wound Care. 2019 Apr 2;28(4):198-203. doi: 10.12968/jowc.2019.28.4.198.

Abstract

Purpura fulminans is a severe and rapidly progressive septic process characterised by the development of haemorrhagic and ecchymotic lesions and skin necrosis. It can appear on any part of the body but predominantly affects the limbs. Purpura fulminans is a rare but possible complication in paediatric patients, especially neonates. It can increase their risk of morbidity and mortality if not treated early and cause a severe long-term condition in survivors of the infectious episode, including amputation. For professionals involved in wound healing, purpura fulminans poses a major challenge. This report describes the case of a premature neonate with extensive purpura fulminans of the legs and arms. Topical treatment of the limbs and purpuric areas with hyperoxygenated fatty acids (HOFAs) every two hours produced an improvement in the lesions. Complete healing was achieved using moist wound healing products. Early topical application of HOFAs appears to be a safe treatment that improves tissue microcirculation in paediatric patients with Purpura fulminans, minimising sepsis-related skin damage.

摘要

暴发性紫癜是一种严重且进展迅速的脓毒症过程,其特征为出现出血性和瘀斑性病变以及皮肤坏死。它可出现在身体的任何部位,但主要影响四肢。暴发性紫癜在儿科患者尤其是新生儿中是一种罕见但可能出现的并发症。如果不及早治疗,会增加其发病和死亡风险,并在感染发作的幸存者中导致严重的长期病症,包括截肢。对于从事伤口愈合工作的专业人员而言,暴发性紫癜构成了一项重大挑战。本报告描述了一名腿部和手臂患有广泛暴发性紫癜的早产新生儿病例。每两小时用高氧脂肪酸(HOFAs)对四肢和紫癜区域进行局部治疗,使病变有所改善。使用湿性伤口愈合产品实现了完全愈合。早期局部应用HOFAs似乎是一种安全的治疗方法,可改善暴发性紫癜儿科患者的组织微循环,将脓毒症相关的皮肤损伤降至最低。

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