title: Case report of a pressure ulcer in an infant receiving extracorporeal life support: the use of a novel mattress surface for pressure reduction.
abstract: 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.
authors.affiliation: Spectrum Health, Grand Rapids, MI, USA. annharris@novagate.com
authors.forename: Ann H
authors.initials: AH
authors.lastname: Harris
authors.forename: Kara L
authors.initials: KL
authors.lastname: Coker
authors.forename: Carla Gianoli
authors.initials: CG
authors.lastname: Smith
authors.forename: Neal
authors.initials: N
authors.lastname: Uitvlugt
authors.forename: Benedict
authors.initials: B
authors.lastname: Doctor
mesh_terms: D001512:Bedding and Linens; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D003668:Pressure Ulcer / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D012867:Skin / Q000033:anatomy & histology; D012879:Skin Physiological Phenomena