Chalian A A, Kagan S H
Department of Otorhinolaryngology/Head and Neck Surgery, School of Medicine, University of Pennsylvania, Philadelphia 19104-4283, USA.
Head Neck. 2001 Jan;23(1):25-8.
The operating room (OR) presents a high-risk environment for pressure injury. We designed a project to improve performance in the prevention of intraoperative pressure ulcers in extended length head and neck surgeries for malignancies (ELS) using a fluid mattress (RIK) intraoperatively.
A descriptive design was used to monitor performance improvement in this underrecognized aspect of patient care. A fluid, pressure-reducing OR mattress (RIK) was compared with the use of a standard foam OR mattress (Skytron). A convenience group of 36 consecutive patients, undergoing ELS, was included in the project. Patients were evaluated for presence or absence of a pressure ulcer immediately and 72 hours postoperatively.
Patient groups were demographically and surgically comparable at a clinical level. Pressure ulcer incidence before intervention was 21% (4 of 19). This declined to 0% after intervention.
Intraoperative pressure ulcers are a costly complication. Presence of a pressure ulcer extends time in the sick role and disrupts desired aesthetic outcomes. Use of a pressure-reducing device achieved the performance improvement objective. Implications for future research and current care are discussed.
手术室是发生压力性损伤的高风险环境。我们设计了一个项目，通过术中使用流体床垫（RIK）来提高恶性肿瘤延长时长头颈手术（ELS）中预防术中压疮的效果。
采用描述性设计来监测在这一未得到充分认识的患者护理方面的性能改善情况。将一种流体减压手术室床垫（RIK）与使用标准泡沫手术室床垫（Skytron）进行比较。该项目纳入了一组连续36例接受ELS手术的便利样本患者。在术后即刻和术后72小时对患者进行压疮有无情况评估。
在临床层面，患者组在人口统计学和手术方面具有可比性。干预前压疮发生率为21%（19例中有4例）。干预后降至0%。
术中压疮是一种代价高昂的并发症。压疮的出现会延长患病时间并破坏预期的美学效果。使用减压装置实现了性能改善目标。讨论了对未来研究和当前护理的启示。
