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手术室压疮风险和发展的评估。

Evaluation of pressure ulcer risk and development in operating rooms.

机构信息

Department of Nursing, Faculty of Health Sciences, Bartın University, Bartın, Turkey.

Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey.

出版信息

J Tissue Viability. 2022 Nov;31(4):707-713. doi: 10.1016/j.jtv.2022.09.001. Epub 2022 Sep 9.

Abstract

AIM

This study aimed to determine the risk and development of pressure ulcers in operating rooms.

MATERIALS AND METHODS

The sample of the study included a total of 250 patients. In the study, the risk of pressure ulcers was assessed before the operation, and the development of pressure ulcers was evaluated within 24 h after the operation.

RESULTS

The risk of pressure ulcers was low before the operation, and Stage I pressure ulcer developed in 12.8% of the patients within 24 h after the operation. The patients had pressure ulcers mostly in their sacrum. Their mean 3S Intraoperative Risk Assessment Scale of Pressure Sore score was 15.68 ± 4.84, suggesting that they were not at risk of developing pressure ulcers. Having a chronic disease (OR = 8.986; 95% CI = 3.697-21.845), undergoing general anesthesia (OR = 3.084; 95% CI = 1.323-7.194), and orthopedic surgery (OR = 10.172; 95% CI = 3.121-33.155) were statistically significant risk factors for pressure ulcers (p < 0.001). Additionally, moderately edematous skin (OR = 3.838; 95% CI = 1.024-14.386), overweight/underweight (OR = 16.333; 95% CI = 3.779-70.602), intraoperative bleeding greater than 800 ml (OR = 13.000; 95% CI = 3.451-48.969), operation time longer than 5 h (OR = 21.667; 95% CI = 2.122-221.223), moderate intraoperative stress (OR = 4.917; 95% CI = 0.425-56.916), body temperature higher than 38.3 °C or lower than 36.1 °C (OR = 5.462; 95% CI = 2.161-13.805), and intraoperative prone position (OR = 3.354; 95% CI = 1.386-8.115) were statistically significant risk factors for the development of pressure ulcers.

CONCLUSION

According to our preoperative pressure ulcer risk assessment, it is very important to take additional protective measures both during and after surgical operations to prevent pressure ulcers.

摘要

目的

本研究旨在确定手术室压疮的风险和发展情况。

材料和方法

研究的样本包括 250 名患者。在研究中,在手术前评估压疮风险,并在手术后 24 小时内评估压疮的发展情况。

结果

手术前压疮风险较低,术后 24 小时内有 12.8%的患者发展为Ⅰ期压疮。患者的压疮主要发生在骶骨处。他们的平均 3S 术中压疮风险评估量表评分为 15.68±4.84,表明他们没有发生压疮的风险。患有慢性病(OR=8.986;95%CI=3.697-21.845)、接受全身麻醉(OR=3.084;95%CI=1.323-7.194)和骨科手术(OR=10.172;95%CI=3.121-33.155)是压疮的统计学显著风险因素(p<0.001)。此外,皮肤中度水肿(OR=3.838;95%CI=1.024-14.386)、超重/体重不足(OR=16.333;95%CI=3.779-70.602)、术中出血量大于 800ml(OR=13.000;95%CI=3.451-48.969)、手术时间超过 5 小时(OR=21.667;95%CI=2.122-221.223)、中度术中应激(OR=4.917;95%CI=0.425-56.916)、体温高于 38.3°C 或低于 36.1°C(OR=5.462;95%CI=2.161-13.805)和术中俯卧位(OR=3.354;95%CI=1.386-8.115)是压疮发展的统计学显著风险因素。

结论

根据我们的术前压疮风险评估,在手术期间和之后采取额外的保护措施非常重要,以预防压疮。

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