THE PERFORMANCE OF SKIN ADVISORY SERVICES IN THE PREVENTION OF PRESSURE INJURY IN PATIENTS WITH COVID-19 IN THE INTENSIVE CARE UNIT

Abstract

The integumentary system is composed of the skin and its appendages, is extremely important in photoprotection, immunology, protection from fluid loss, thermoregulation, production of vitamin D, maintenance of fluid and electrolyte balance, perception of painful and pleasant stimuli and is an indicator of health and illness. The skin in its total integrity defends us from the penetration of microorganisms from the normal flora and from microorganisms from the hospital environment, when it is broken, it loses its protective capacity, leaving patients vulnerable to infections. In the COVID 19 pandemic, we observed an incidence of pressure injuries caused in patients bedridden in ICU beds, due to hemodynamic instability, many of them needed a prone position to facilitate breathing patterns and, therefore, made it difficult to implement prevention techniques, favoring the appearance of pressure injury. Therefore, to carry out this work, qualitative research tools were used in a virtual way, such as manuals, ministerial guides, ANVISA protocols and articles indexed in Scielo. Skin counseling made up of technicians and nurses qualified in the prevention and treatment of injuries, contribute to the implementation of techniques that minimize or eliminate the incidence of pressure injuries, using decubitus change checklist, head and arm repositioning guidelines every 2 hours, placement of pads adapted to pressure areas, hydropolymer and silicone foam (inframammary region, abdominal region, face, jaw and toes), orientations, passive changes in 15º for 15 seconds in the upper and lower limbs, skin hydration in areas without erythema, application of cream based on zinc oxide and dimethicone in regions that are more sensitive to aggression. We observed that with simple preventive measures, we can minimize the appearance of new lesions and deep tissue involvement when the patient is supine. The monitoring of skin counseling together with sector health professionals, engaged in preventive actions, will achieve better results, when compared to the fractional implementation of prevention measures, which is one of the most important tools for dehospitalization, infection control and rehabilitation of patients affected by COVID-19.