University of Pittsburgh, School of Health and Rehabilitation Sciences, 6425 Penn Ave, Suite 401, Pittsburgh, PA, 15206, USA.
UT Health San Antonio, Department of Occupational Therapy, 7703 Floyd Curl Dr, San Antonio, TX, 78229, USA.
J Tissue Viability. 2021 Feb;30(1):9-15. doi: 10.1016/j.jtv.2020.12.006. Epub 2021 Jan 2.
Guidelines for pressure injury prevention consider the use of pressure-redistributing pads to prevent tissue deformation. However, limited research exists to assess the pressure distribution provided by the operating tables and the effectiveness of pressure-redistributing pads in preventing pressure injuries. In this study, we compared the pressure distribution properties of two surgical table pads and identified parameters influencing pressure injury outcomes after a lengthy surgical procedure. Twenty-seven patients undergoing left ventricular assist device implantation surgery participated in the study. Participants were randomly assigned to use either an air cell-based pad or a gel pad. Interface pressure was recorded during the surgery. We analyzed the effect of surgical table pad type, interface pressure distribution and pressure injury outcomes and analyzed what characteristics of the patients and the interface pressure are most influential for the development of pressure injuries. Comparing the interface pressure parameters between the air-cell group and the gel group, only the peak pressure index x time was significantly different (p < 0.05). We used univariate logistic regression analysis to identify significant predictors for the pressure injury outcome. The support surface was not significant. And, among patient characteristics, only age and BMI were significant (p ≤ 0.05). Among the interface pressure parameters, pressure density maxima, peak pressure index x time, and coefficient of variation were significant for pressure injury outcome (p ≤ 0.05). Peak pressure index, average pressure, and the surgery length were not statistically significant for pressure injury outcomes.
压力性损伤预防指南考虑使用压力再分布垫来防止组织变形。然而，评估手术台提供的压力分布和压力再分布垫在预防压力性损伤方面的效果的研究有限。在这项研究中，我们比较了两种手术台垫的压力分布特性，并确定了在长时间手术过程后影响压力性损伤结果的参数。27 名接受左心室辅助装置植入手术的患者参与了这项研究。参与者被随机分配使用气室垫或凝胶垫。在手术过程中记录界面压力。我们分析了手术台垫类型、界面压力分布和压力性损伤结果的影响，并分析了患者和界面压力的哪些特征对压力性损伤的发展最有影响。比较气室组和凝胶组的界面压力参数，只有峰值压力指数 x 时间有显著差异（p<0.05）。我们使用单变量逻辑回归分析来确定压力性损伤结果的显著预测因子。支撑面不显著。并且，在患者特征中，只有年龄和 BMI 有显著差异（p≤0.05）。在界面压力参数中，压力密度最大值、峰值压力指数 x 时间和变异系数对压力性损伤结果有显著影响（p≤0.05）。峰值压力指数、平均压力和手术时间对压力性损伤结果没有统计学意义。
