Joseph Jain, McLaughlin Dylan, Darian Vigen, Hayes Lillian, Siddiqui Aamir
Jain Joseph, MD, Plastic and Reconstructive Surgery, Summit Medical Group, Berkeley Heights, New Jersey. Dylan McLaughlin, MS, Wayne State University, School of Medicine, Detroit, Michigan. Vigen Darian, MD, Division of Plastic and Reconstructive Surgery, Henry Ford Hospital, Detroit, Michigan. Lillian Hayes, BS, Division of Surgical Research, Henry Ford Hospital, Detroit, Michigan. Aamir Siddiqui, MD, Division of Plastic and Reconstructive Surgery, Henry Ford Hospital, Detroit, Michigan.
J Wound Ostomy Continence Nurs. 2019 Jan/Feb;46(1):13-17. doi: 10.1097/WON.0000000000000497.
The purpose of this study was to evaluate the effect of a low-profile alternating pressure (AP) overlay system on hospital-acquired pressure injuries (HAPIs).
Prospective case series with historical controls.
The study setting was the operating room and critical care unit of an urban quaternary care hospital in the Midwestern United States. One hundred neurosurgery patients undergoing surgery for 2 hours or longer in supine position were included in the study (AP group). The outcomes for the AP group were compared to a historical control group of 292 patients.
A group of 100 patients were prospectively placed on the AP overlay during surgery. Participants were enrolled preoperatively and tracked by the research team during their hospital stay. Demographic data, details of the operation, and pressure injury risk factors were recorded. Following surgery, AP group patients were evaluated daily and continued on standard protocol for pressure injury prevention. The primary study outcome was HAPI rate during the perioperative period (up to 5 days postsurgery) for the AP group (plus standard of care) compared to the standard of care alone (historical control). Control group data were extracted from electronic health records for the prior 2 years. A written questionnaire was given to the care team that used the AP technology; items queried the degree of acceptance of the overlay by surgeons and the operating room and intensive care unit (ICU) staff.
None of the patients in the AP group developed perioperative pressure injuries. Review of historical control group revealed a 6% perioperative pressure injury incidence (18 pressure injuries in a group of 292 patients). Responses on the written questionnaire indicated that the AP technology was well accepted by surgeons and the operating room and ICU staff. There were no adverse events.
Study findings suggest that AP overlay system can safely and reliably be used during neurological surgeries. Findings further suggest that using the AP product may improve outcomes with respect to perioperative HAPIs, including patients deemed at high risk for pressure injury development. Further studies are underway to evaluate the use of this AP overlay system beyond the operating room for more comprehensive care.
本研究旨在评估一种低轮廓交替压力（AP）垫系统对医院获得性压力性损伤（HAPI）的影响。
采用历史对照的前瞻性病例系列研究。
研究地点为美国中西部一家城市四级护理医院的手术室和重症监护病房。100例接受2小时或更长时间仰卧位手术的神经外科患者纳入研究（AP组）。将AP组的结果与292例患者的历史对照组进行比较。
一组100例患者在手术期间前瞻性地使用AP垫。参与者在术前入组，并在住院期间由研究团队进行跟踪。记录人口统计学数据、手术细节和压力性损伤风险因素。术后，对AP组患者每天进行评估，并继续采用预防压力性损伤的标准方案。主要研究结果是AP组（加上标准护理）与单独标准护理（历史对照）相比，围手术期（术后5天内）的HAPI发生率。对照组数据从过去2年的电子健康记录中提取。向使用AP技术的护理团队发放书面问卷；问题询问了外科医生以及手术室和重症监护病房（ICU）工作人员对垫子的接受程度。
AP组患者在围手术期均未发生压力性损伤。对历史对照组的回顾显示，围手术期压力性损伤发生率为6%（292例患者中有18例发生压力性损伤）。书面问卷的回复表明，AP技术得到了外科医生以及手术室和ICU工作人员的良好接受。未发生不良事件。
研究结果表明，AP垫系统可在神经外科手术期间安全可靠地使用。研究结果还表明，使用AP产品可能会改善围手术期HAPI的结局，包括被认为发生压力性损伤风险较高的患者。正在进行进一步研究，以评估这种AP垫系统在手术室以外的使用情况，以提供更全面的护理。
