Karina Karina, Rahmania Dinar, Andrew Hubert, Ekaputri Krista, Biben Johannes Albert, Martina Nungki Ratna
Klinik Hayandra, Yayasan Hayandra Peduli, Jakarta Pusat, Indonesia; HayandraLab, Yayasan Hayandra Peduli, Jakarta Pusat, Indonesia; Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia.
Department of Plastic and Reconstructive Surgery, Dr. Ramelan Navy Hospital, Surabaya.
Wounds. 2023 Jan;35(1):E14-E16. doi: 10.25270/wnds/22002.
Pressure injuries remain a major burden worldwide with associated morbidity and financial implications. Patients in the ICU, such as those with severe COVID-19, are especially susceptible to PI as they remain immobile for extended durations while intubated.
This report examines a case of stage 4 PI in a senior COVID-19 survivor treated with adjunct intravenous and intralesional aaPRP therapy in addition to topical hyaluronic acid/silver sulfadiazine cream and framycetin sulphate dressing.
aaPRP therapy was administered via intralesional injection and intravenous infusion 4 times with 2 weeks between therapies, while the aforementioned topical cream and dressing were applied every 2 days between visits. The patient also had controlled diabetes which may affect the wound healing process.
This report concludes with a discussion of how COVID-19 carries important dynamics in the pathogenesis of PI and how adjunct administration of intravenous and intralesional aaPRP, which is abundant in regenerative proteins, may be beneficial in the management of PI.
压力性损伤仍然是全球范围内的一个主要负担，会带来相关的发病率和经济影响。重症监护病房（ICU）的患者，如患有严重新型冠状病毒肺炎（COVID-19）的患者，特别容易发生压力性损伤，因为他们在插管期间长时间保持不动。
本报告探讨了一名老年COVID-19幸存者发生4期压力性损伤的病例，该患者除接受外用透明质酸/磺胺嘧啶银乳膏和硫酸新霉素敷料治疗外，还接受了辅助静脉和病灶内自体富血小板血浆（aaPRP）治疗。
aaPRP治疗通过病灶内注射和静脉输注进行，共4次，每次治疗间隔2周，同时在每次就诊期间每2天使用上述外用乳膏和敷料。患者还患有得到控制的糖尿病，这可能会影响伤口愈合过程。
本报告最后讨论了COVID-19在压力性损伤发病机制中的重要动态变化，以及富含再生蛋白的静脉和病灶内aaPRP辅助给药在压力性损伤管理中可能如何有益。
