Taghiloo Hamed, Ebadi Abbas, Saeid Yaser, Jalali Farahni Alireza, Davoudian Atefeh
MSc in Operating Room, School of Nursing Baqiyatallah University of Medical Sciences Tehran Iran.
Behavioral Sciences Research Centre, Life Style Institute, School of Nursing Baqiyatallah University of Medical Sciences Tehran Iran.
Health Sci Rep. 2023 Mar 17;6(3):e1148. doi: 10.1002/hsr2.1148. eCollection 2023 Mar.
Cardiac surgical patients are highly prone to developing surgery-related Pressure injuries (PIs). Prevention of PIs is an important patient safety priority in healthcare settings and patients care. So the aim of this study is to detect the effectiveness of prevention strategies to decrease PIs prevalence and incidence in patients undergoing open heart surgery.
We identified studies through Web of Science, Scopus, PubMed, Cochrane, and ProQuest databases from inception through September 2022 with restrictions on the English language. Cochrane RoB 2, JBI, and NIH checklist were carried out as critical appraisal Tools to investigate the studies risk of bias. Finally, 10 studies with a total sample No. 1348, which fulfilled eligibility criteria were included in final systematic review.
Most common interventions investigated in included studies were addressing impairments skin care which included the use of multilayer silicone foam, Care bundle and multiple intervention programs, alternative head inflatable pads, pressure-reducing foam mattresses, and electric bed frames as the effective PIs Prevention (PIP) strategies. While repositioning is one of the important causes mentioned in most PIP protocols, there was not adequate evidence to recommend any special turning regimens for PIP.
Given current evidence, multilayer silicone foam, Care bundle and multiple intervention programs, alternative inflatable head pads, pressure-reducing foam mattresses, and electric bed frames are effective strategies to prevent pressure ulcers. Further investigations are needed to specify the cost-effectiveness of mentioned strategies and RCTs to determine other PIP strategies such as repositioning and mobilization, nutritional supplementation, creams, and co-interventions effects.
心脏外科手术患者极易发生与手术相关的压力性损伤（PI）。预防PI是医疗机构患者安全的重要优先事项以及患者护理的重要内容。因此，本研究旨在检测预防策略对降低心脏直视手术患者PI患病率和发病率的有效性。
我们通过科学网、Scopus、PubMed、Cochrane和ProQuest数据库检索从建库至2022年9月的研究，限定语言为英文。采用Cochrane RoB 2、JBI和美国国立卫生研究院清单作为关键评估工具，以调查研究的偏倚风险。最终，10项研究共1348例样本符合纳入标准，被纳入最终的系统评价。
纳入研究中调查的最常见干预措施是针对皮肤护理损伤，包括使用多层硅胶泡沫、护理包和多干预方案、替代头部充气垫、减压泡沫床垫和电动床架作为有效的PI预防（PIP）策略。虽然重新定位是大多数PIP方案中提到的重要原因之一，但没有足够的证据推荐任何特殊的翻身方案用于PIP。
根据现有证据，多层硅胶泡沫、护理包和多干预方案、替代充气头垫、减压泡沫床垫和电动床架是预防压疮的有效策略。需要进一步研究以明确上述策略的成本效益，并开展随机对照试验以确定其他PIP策略，如重新定位和活动、营养补充、乳膏以及联合干预的效果。
