Primiano Mike, Friend Michael, McClure Connie, Nardi Scott, Fix Lisa, Schafer Marianne, Savochka Kathlyn, McNett Molly
Department of Nursing, MetroHealth Medical Center, Cleveland, OH, USA.
AORN J. 2011 Dec;94(6):555-66. doi: 10.1016/j.aorn.2011.03.014.
Pressure ulcer formation related to positioning while in the OR increases the length of hospital stay and hospital costs, but there is little evidence documenting how positioning devices used in the OR influence pressure ulcer development when examined with traditional risk factors. The aim of this prospective cohort study was to identify the prevalence of and risk factors associated with pressure ulcer development among patients undergoing surgical procedures lasting longer than three hours. Participants included all adult same-day admission patients scheduled for a three-hour surgical procedure during an eight-month period (N = 258). Data were gathered preoperatively, intraoperatively, and postoperatively on pressure ulcer risk factors. Bivariate analyses indicated that the type of positioning (ie, heels elevated) (χ(2) = 7.897, P = .048), OR bed surface (ie, foam table pad) (χ(2) = 15.848, P = .000), skin assessment in the postanesthesia care unit (χ(2) = 41.652, P = .000), and male gender (χ(2) = 6.984, P = .030) were associated with pressure ulcer development. Logistic regression analyses indicated that the use of a foam pad (β = 2.691, P = .024) and a lower day-one Braden score (β = .244, P = .003) were predictive of pressure ulcers.
手术室中因体位导致的压疮形成会增加住院时间和住院费用，但几乎没有证据表明，在考虑传统风险因素时，手术室中使用的体位辅助设备如何影响压疮的发生。这项前瞻性队列研究的目的是确定手术时间超过三小时的患者中压疮发生的患病率及相关风险因素。研究对象包括在八个月期间计划进行三小时手术的所有当日入院成年患者（N = 258）。在术前、术中和术后收集有关压疮风险因素的数据。双变量分析表明，体位类型（即足跟抬高）（χ(2)= 7.897，P = .048）、手术室床面类型（即泡沫手术台垫）（χ(2)= 15.848，P = .000）、麻醉后护理单元的皮肤评估（χ(2)= 41.652，P = .000）以及男性（χ(2)= 6.984，P = .030）与压疮形成有关。逻辑回归分析表明，使用泡沫垫（β = 2.691，P = .024）和较低的术后第一天布拉德评分（β = .244，P = .003）可预测压疮。
