Bilateral anterior superior iliac spine pressure ulcers: a case report.
The most frequent sites for pressure ulcers are the occiput, sacrum, ischial tuberosities, trochanters, lateral malleoli, and posterior heels. A 27-year-old woman with Wegener's granulomatosis was admitted to our rehabilitation unit after spending 65 days in an intensive care unit and 40 days in an internal medicine ward. She required mechanical ventilation because of respiratory failure. Adequate oxygenation was only achieved in the prone position. As a result, she developed bilateral anterior superior iliac spine pressure ulcers. Pressure ulcers in this location have not been reported in the literature. Complicating factors included variable levels of oxygenation, malnutrition, anemia, and steroid therapy. Complete healing, documented with serial photographs, occurred over 9 months. Although prone positioning can improve pulmonary gas exchange, it exposes the patient to unique complications. When it is required, specific care should be directed to the unusual weight-bearing surfaces to avoid pressure ulcers.
Dudek
Nancy L
NL
Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Ottawa, Ottawa, Ont, Canada. ndudek@ottawahospital.on.ca
Buenger
Usha R
UR
Trudel
Guy
G
D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006801:Humans; D007085:Ilium; D003668:Pressure Ulcer / Q000209:etiology*; D016684:Prone Position; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D013997:Time Factors; D014945:Wound Healing / Q000187:drug effects
D005938:Glucocorticoids