Article ID: 2025-0147
Objectives: Prone positioning is a well-established intervention to improve oxygenation in patients with acute respiratory distress syndrome. During the coronavirus disease 2019 (COVID-19) pandemic, its use has become widespread, particularly among patients receiving mechanical ventilation. Prolonged prone positioning has been associated with an increased risk of anterior pressure ulcers, including facial involvement.
Methods: Among 305 patients with COVID-19 treated with prone positioning therapy at our institution, 99 developed pressure ulcers and five were diagnosed with Stage III facial pressure ulcers according to the National Pressure Ulcer Advisory Panel classification. We analyzed the clinical features and therapeutic approaches.
Results: Stage I and Stage II pressure ulcers were managed conservatively with topical ointments and wound dressings. Stage III pressure ulcers required debridement and delayed primary closure. Treatment approaches clearly differed between Stage I/II and Stage III pressure ulcers.
Conclusions: This report highlights the importance of pressure ulcer staging in guiding appropriate treatment strategies for prone-position-related facial ulcers in patients with COVID-19. The results of this report underscore the importance of stage-based pressure ulcer treatment, along with proactive prevention and individualized care.
