An Unusual Location for a Pressure Ulcer
Appropriate placement of the ventilation mask is key to the success of noninvasive ventilation treatment. Hence, straps are used to hold the mask in position. The straps must be under appropriate tension; loose straps can cause air to leak, whereas excessively tight straps can lead to the development of skin lesions and pressure ulcers over the nasal bridge. Pressure, friction, or shear forces may also cause pressure ulcers.
The proximal dorsal nasal skin is thin, delicate, and sensitive to trauma. Moreover, the skin of older patients is fragile, inelastic, and easily injured. The thin dorsal nasal skin is more pressure-sensitive because there is little dorsal nasal soft tissue present between bone and skin. Elderly patients with respiratory insufficiency who are given respiratory support with a mask can develop pressure ulcers within a short period of time. Especially on intensive care units, any reduction in patient consciousness may be an additional risk factor for the development of a pressure ulcer over the nasal bridge.
Discussion
Appropriate placement of the ventilation mask is key to the success of noninvasive ventilation treatment. Hence, straps are used to hold the mask in position. The straps must be under appropriate tension; loose straps can cause air to leak, whereas excessively tight straps can lead to the development of skin lesions and pressure ulcers over the nasal bridge. Pressure, friction, or shear forces may also cause pressure ulcers.
The proximal dorsal nasal skin is thin, delicate, and sensitive to trauma. Moreover, the skin of older patients is fragile, inelastic, and easily injured. The thin dorsal nasal skin is more pressure-sensitive because there is little dorsal nasal soft tissue present between bone and skin. Elderly patients with respiratory insufficiency who are given respiratory support with a mask can develop pressure ulcers within a short period of time. Especially on intensive care units, any reduction in patient consciousness may be an additional risk factor for the development of a pressure ulcer over the nasal bridge.
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