Nursing Department, Veteran General Hospital, Taipei, Taiwan.
Biol Res Nurs. 2011 Oct;13(4):419-24. doi: 10.1177/1099800410392772. Epub 2010 Dec 30.
The purpose of this study was to evaluate the effect of high-density foam (HDF) pads versus viscoelastic polymer (VP) pads in the prevention of pressure ulcer formation during spinal surgery and their cost-effectiveness. Subjects were 30 patients who underwent spinal surgery for more than 3 hr in a prone position. One side of the chest and iliac crest was padded with HDF pads and the other side was padded with VP pads. An Xsensor® pressure measuring sheet was placed between the pad and the patient. Bilateral chest and iliac crest points were observed for the presence of pressure ulcers at 30 min after the operation. Results showed that a pressure ulcer had occurred at 9 of 120 compression points (7.5% of the total), 30 min after the operation. Risk evaluation showed that female gender, weight <50 kg, and body mass index (BMI) <18 kg/m(2) as well as location (the iliac crest) were all risk factors for development of pressure ulcers. The most significant factor was BMI <18 kg/m(2). The average and peak pressures measured at the points padded with the VP pads were significantly lower than those padded with the HDF pads. However, there was no significant difference between the VP and the HDF pads regarding ulcer prevention. Because the cost of a VP pad is 250 times greater than that of an HDF pad of similar size, the VP pad should only be considered for use in high-risk patients.
本研究旨在评估在预防脊柱手术中发生压疮方面，高密度泡沫（HDF）垫与粘弹性聚合物（VP）垫的效果及其成本效益。研究对象为 30 名接受俯卧位超过 3 小时脊柱手术的患者。一侧胸部和髂嵴使用 HDF 垫填充，另一侧使用 VP 垫填充。在垫和患者之间放置 Xsensor®压力测量片。术后 30 分钟观察双侧胸部和髂嵴的压疮发生情况。结果显示，9/120 个受压点（总受压点的 7.5%）在术后 30 分钟出现压疮。风险评估显示，女性、体重<50kg、体质量指数（BMI）<18kg/m2 以及部位（髂嵴）均为压疮发生的危险因素。BMI<18kg/m2 是最重要的危险因素。VP 垫所测的各点的平均和峰值压力明显低于 HDF 垫。但是，VP 垫和 HDF 垫在预防溃疡方面没有显著差异。由于 VP 垫的成本是同等大小 HDF 垫的 250 倍，VP 垫仅应考虑用于高危患者。
