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一项随机对照试验,比较长时间手术期间交替压力垫与凝胶垫联合使用和单独使用凝胶垫时的界面压力。

A randomized controlled trial to compare the interface pressures of alternating pressure overlay with gel pad versus gel pad alone during prolonged surgery.

作者信息

Neo Tze Guan, Koo Seok Hwee, Chew Samuel Teong Huang, Png Gek Kheng, Lacuesta Mary Jojie, Wu Margie Ya Lan, Tay Ramona Yu Ching, Singh Prit Anand, Chandran Rajkumar

机构信息

Department of Nursing, Changi General Hospital, Singapore.

Clinical Trials and Research Unit, Changi General Hospital, Singapore.

出版信息

J Tissue Viability. 2021 May;30(2):222-230. doi: 10.1016/j.jtv.2021.02.003. Epub 2021 Feb 6.

DOI:10.1016/j.jtv.2021.02.003
PMID:33612359
Abstract

INTRODUCTION

Prolonged surgery is a known risk of pressure ulcer formation. Pressure ulcers affect the quality of life, are a significant cause of morbidity and mortality, and pose a burden on the healthcare system. This study aimed to compare the effectiveness of an alternating pressure (AP) overlay with Gel pad against the Gel pad in reducing interface pressure (IP) during prolonged surgery.

METHODS

A total of 180 participants from a tertiary hospital were randomized to AP overlay with Gel pad group (n = 90) and Gel pad group (n = 90). Patients were placed supine on the pressure redistributing surfaces, and IP data under the sacrum and ischial tuberosities were collected at an interval of 30 min from 0 min up to a maximum of 570 min.

RESULTS

Based on data from 133 participants, the average IPs during all the deflation cycles of the AP overlay (with Gel pad) were significantly lower than the average continuous IP recorded for Gel pad throughout the measuring period (p < 0.001). Only three patients (2.26% of study participants) - Gel pad group (n = 2; 2.99%) and AP overlay with Gel pad group (n = 1; 1.52%) developed post-operative pressure ulcer (p = 0.5687).

CONCLUSIONS

The lower IP during deflation cycles of the AP overlay (with Gel pad) suggests its potential effectiveness in preventing pressure ulcer formation in patients undergoing prolonged surgery. The prevention and reduction of pressure ulcers will have a considerable impact on the improved quality of life and cost savings for the patient. The study findings may facilitate the formulation of policies for preventing pressure ulcer development in the perioperative setting.

摘要

引言

长时间手术是已知的发生压疮的风险因素。压疮会影响生活质量,是发病和死亡的重要原因,还给医疗系统带来负担。本研究旨在比较交替压力(AP)床垫加凝胶垫与单纯凝胶垫在长时间手术期间降低界面压力(IP)方面的效果。

方法

一家三级医院的180名参与者被随机分为AP床垫加凝胶垫组(n = 90)和凝胶垫组(n = 90)。患者仰卧于压力重新分布的表面,从0分钟开始,每隔30分钟收集一次骶骨和坐骨结节下方的IP数据,最长收集570分钟。

结果

基于133名参与者的数据,AP床垫(加凝胶垫)所有放气周期的平均IP显著低于整个测量期间单纯凝胶垫记录的平均持续IP(p < 0.001)。只有三名患者(占研究参与者的2.26%)——凝胶垫组(n = 2;2.99%)和AP床垫加凝胶垫组(n = 1;1.52%)发生了术后压疮(p = 0.5687)。

结论

AP床垫(加凝胶垫)放气周期期间较低的IP表明其在预防长时间手术患者发生压疮方面可能有效。预防和减少压疮将对改善患者生活质量和节省费用产生重大影响。研究结果可能有助于制定围手术期预防压疮发生的政策。

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