The COVID-19 pandemic has changed the world in 2020. It also has created “the perfect storm for skin and wound issues.”¹ Our presentation at SAWC Fall Virtual takes a closer look at how the coronavirus has changed skin and wound care, focusing on nine topics arising in wound centers.

COVID skin. The condition known as COVID skin “may present as a rash, discolored skin, or open wound. It may show up as an early symptom in the young, or a later COVID-19 outcome in the old. It may be on the chest, back, hands, or toes.”¹ Post-acute settings such as home health and skilled facilities should develop a coordinated effort with the American Academy of Dermatology and hospice for data collection.

Pressure injury prevention. Measures for mobility, consistency in care, and skin care considerations transcend COVID-19. Consider the association between COVID-19 risks and pressure injury risks. Possible solutions include a team approach to improve mobility, the use of neighborhood cohorts, and increased skin observations.

Proning. Undertake increased skin observations. Consider other associated prone injuries and effects on skin. Initiate respiratory positioning programs to improve oxygenation.

Medical device-related pressure injury. How are staff addressing/coping with medical device-related pressure injury assessment, documentation, and management?

What solutions have been developed and what lessons have been learned?

Personal protective equipment (PPE) skin issues. The PPE required in the presence of COVID-19 has resulted in skin issues for staff members.¹ What are the lessons learned for preventing and treating PPE skin issues experienced by staff? Are there recommendations for future outbreak management?

Telehealth. We have been seeing more incorporation of telehealth into wound care since the pandemic began. Although staff and patients have adjusted, there is a learning curve, and not everybody knows how to use telehealth. Set up guidelines of who can use telehealth, and why telehealth visits can and should be done.

The team approach to wound and skin care. How did your idea of the “team” change because of COVID-19? What new things did you observe? What are some new insights for future outbreak management?

Nutrition and weight loss. COVID-19 does pose a risk factor for weight loss because the virus affects the senses of taste and smell.² Understanding the physiological impact on COVID-19 shifts conversations in wound management.

Confinement and isolation. Recent research indicated that there may be consequences for patients who are isolated due to COVID-19.³ What physical and psychosocial consequences have you observed to date? What outcomes should we be watching as the pandemic continues?

References

1. Britton J, Costa T, Grosso M, et al. How COVID-19 is changing skin: post-acute care wound experts from across the United States speak out. Wound Manag Prev. 2020;66(9):5–7.

2. Menni C, Valdes A, Freydin MB, et al. Loss of smell and taste in combination with other symptoms is a strong predictor of COVID-19 infection. Nat Med. 2020. doi:10.1038/s41591-020-0916-2

3. Krendl AC, Perry BL. The impact of sheltering in place during the COVID-19 pandemic on older adults’ social and mental well-being. J Gerontol B Psychol Sci Soc Sci. 2020; epub Aug. 11. doi:10.1093/geronb/gbaa110

To watch the presentation, click here.