Hair braids as a risk factor for occipital pressure ulcer development: a case study

Area of Science:

• Pediatric critical care medicine
• Dermatology
• Wound care

Background:

• Pressure ulcers are a significant concern in acute care, particularly for critically ill patients in intensive care units (ICUs).
• Occipital pressure ulcer development is linked to immobility, young age, and medical devices, but other factors may contribute.
• Pediatric intensive care units (PICUs) present unique challenges for pressure ulcer prevention.

Purpose of the Study:

• To report a case of occipital pressure ulcers in a pediatric patient with severe sepsis and multi-organ failure.
• To identify hair braids as a potential, previously unrecognized risk factor for occipital pressure injury in immobile pediatric patients.
• To emphasize the importance of patient and staff education regarding hair management in preventing pressure ulcers.

Main Methods:

• Case study of a 7-year-old boy admitted to the PICU with severe sepsis and multi-organ failure.
• Clinical observation and documentation of wound development over a 4-week period.
• Assessment of potential contributing factors, including patient immobility and hair care practices.

Main Results:

• The patient developed five full-thickness occipital pressure ulcers after 4 weeks of immobility with hair in braids.
• The occipital lesions eventually healed, but resulted in scarring alopecia.
• This case highlights a novel association between hair braids and occipital pressure damage.

Conclusions:

• Hair braids, in conjunction with immobility in critically ill children, represent a potential risk factor for occipital pressure ulcers.
• Educating patients, families, and healthcare staff on releasing hair is crucial for preventing these injuries.
• Proactive hair management strategies should be integrated into pressure ulcer prevention protocols for pediatric ICU patients.