Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients
Summary:. Due to the spread of the coronavirus disease 2019 pandemic, an increasing number of ill patients have been admitted to intensive care unit requiring mechanical ventilation. Although prone positioning is considered beneficial, long periods in this position may induce important complications...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-11-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004705 |
| _version_ | 1797988246579314688 |
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| author | Marco Pappalardo, MD, PhD Marta Starnoni, MD Federico De Maria, MD Francesca Lolli, MD Antonio Pedone, MD Alessio Baccarani, MD, FACS Giorgio De Santis, MD |
| author_facet | Marco Pappalardo, MD, PhD Marta Starnoni, MD Federico De Maria, MD Francesca Lolli, MD Antonio Pedone, MD Alessio Baccarani, MD, FACS Giorgio De Santis, MD |
| author_sort | Marco Pappalardo, MD, PhD |
| collection | DOAJ |
| description | Summary:. Due to the spread of the coronavirus disease 2019 pandemic, an increasing number of ill patients have been admitted to intensive care unit requiring mechanical ventilation. Although prone positioning is considered beneficial, long periods in this position may induce important complications, including pressure ulcers in high-risk and uncommon body areas. We report five cases of pressure ulcer necrosis of the chin in coronavirus disease 2019 patients as a consequence of mechanical ventilation in prone positioning using autologous fat grafting (AFG) as a secondary technique. A series of five patients with secondarily-healed chin necrosis treated by AFG between February and June 2020 were reviewed. All patients had been treated initially with surgical debridement followed by conservative treatment. Secondary AFG was performed to reduce patient’s pain, improve chin contour-projection, and minimize cosmetic sequelae and scarring. Patient satisfaction was assessed using a five-point Likert scale (0–4). Vancouver scale was used to evaluate the chin scars clinically. The average amount of fat injected into the chin area was 8.1 ± 2.0 ml. At 6-month follow-up, all patients were mostly satisfied (average Likert-scale 3.2 ± 0.4). Based on the Vancouver scale, improvement of the chin scar from 9.5 ± 0.8 to 4.7 ± 0.8 was found. We report a positive experience with secondary AFG for correction of painful and unaesthetic scarring and contour abnormality following surgical debridement and secondary-intention healing of chin pressure ulcers. |
| first_indexed | 2024-04-11T07:59:48Z |
| format | Article |
| id | doaj.art-fa8326e903454cdf84cd63759a539c32 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-11T07:59:48Z |
| publishDate | 2022-11-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-fa8326e903454cdf84cd63759a539c322022-12-22T04:35:47ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-11-011011e470510.1097/GOX.0000000000004705202211000-00035Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 PatientsMarco Pappalardo, MD, PhD0Marta Starnoni, MD1Federico De Maria, MD2Francesca Lolli, MD3Antonio Pedone, MD4Alessio Baccarani, MD, FACS5Giorgio De Santis, MD6From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.From the Division of Plastic and Reconstructive Surgery, Department of Medical and Surgical Sciences, Policlinico University Hospital, University of Modena and Reggio Emilia, Modena, Italy.Summary:. Due to the spread of the coronavirus disease 2019 pandemic, an increasing number of ill patients have been admitted to intensive care unit requiring mechanical ventilation. Although prone positioning is considered beneficial, long periods in this position may induce important complications, including pressure ulcers in high-risk and uncommon body areas. We report five cases of pressure ulcer necrosis of the chin in coronavirus disease 2019 patients as a consequence of mechanical ventilation in prone positioning using autologous fat grafting (AFG) as a secondary technique. A series of five patients with secondarily-healed chin necrosis treated by AFG between February and June 2020 were reviewed. All patients had been treated initially with surgical debridement followed by conservative treatment. Secondary AFG was performed to reduce patient’s pain, improve chin contour-projection, and minimize cosmetic sequelae and scarring. Patient satisfaction was assessed using a five-point Likert scale (0–4). Vancouver scale was used to evaluate the chin scars clinically. The average amount of fat injected into the chin area was 8.1 ± 2.0 ml. At 6-month follow-up, all patients were mostly satisfied (average Likert-scale 3.2 ± 0.4). Based on the Vancouver scale, improvement of the chin scar from 9.5 ± 0.8 to 4.7 ± 0.8 was found. We report a positive experience with secondary AFG for correction of painful and unaesthetic scarring and contour abnormality following surgical debridement and secondary-intention healing of chin pressure ulcers.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004705 |
| spellingShingle | Marco Pappalardo, MD, PhD Marta Starnoni, MD Federico De Maria, MD Francesca Lolli, MD Antonio Pedone, MD Alessio Baccarani, MD, FACS Giorgio De Santis, MD Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients Plastic and Reconstructive Surgery, Global Open |
| title | Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients |
| title_full | Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients |
| title_fullStr | Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients |
| title_full_unstemmed | Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients |
| title_short | Secondary Autologous Fat Grafting for the Treatment of Chin Necrosis as a Consequence of Prone Position in COVID-19 Patients |
| title_sort | secondary autologous fat grafting for the treatment of chin necrosis as a consequence of prone position in covid 19 patients |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004705 |
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