Hara Kentaro, Uemura Takahiro, Tachibana Reika, Kumashiro Ryosuke, Yamaguchi Michiko, Kawahara Ichiro, Fujioka Masaki
Operation Center Division, National Hospital Organization Nagasaki Medical Center, Nagasaki, JPN.
Healthcare Management Research Center, Chiba University Hospital, Chiba, JPN.
Cureus. 2024 Apr 18;16(4):e58552. doi: 10.7759/cureus.58552. eCollection 2024 Apr.
Background In neurosurgical procedures where the park bench position is employed, the risk of perioperative pressure injuries is elevated due to the limited contact surface area, with the head and part of the upper torso extending beyond the surgical table. This study aimed to examine the effects of preventative measures against such injuries, proposing a potential standard for postural fixation in these surgeries. Methods Conducted at a medical center, from January 2017 to March 2023, this prospective cohort study involved participants aged 20 and above who underwent neurosurgical procedures in the park bench position under general anesthesia. The focus was on comparing the incidence of pressure injuries between intervention and control groups. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results Out of 65 patients enrolled, 28 were assigned to each of the intervention and control groups. The control group experienced 17 instances of postoperative pressure injuries and skin disorders in areas prone to pressure, such as the axillary and greater trochanter regions. Conversely, the intervention group reported no such incidents, underscoring the efficacy of meticulous surgical positioning and management of bodily pressure, temperature, humidity, and microclimate. Conclusion Implementing preventive measures in neurosurgical park bench procedures significantly reduces the incidence of postoperative pressure injuries and skin disorders. These findings advocate for the adoption of standardized postural fixation protocols in such surgeries, potentially influencing global clinical practices in neurosurgery.
背景 在采用公园长椅体位的神经外科手术中，由于接触表面积有限，头部和上半身的一部分超出手术台，围手术期发生压力性损伤的风险会升高。本研究旨在探讨针对此类损伤的预防措施的效果，提出这些手术中体位固定的潜在标准。方法 本前瞻性队列研究于2017年1月至2023年3月在一家医疗中心进行，纳入年龄在20岁及以上、在全身麻醉下采用公园长椅体位进行神经外科手术的参与者。重点是比较干预组和对照组压力性损伤的发生率。该研究遵循了加强流行病学观察性研究报告（STROBE）指南。结果 在纳入的65例患者中，干预组和对照组各有28例。对照组在易受压区域，如腋窝和大转子区域，出现了17例术后压力性损伤和皮肤疾病。相反，干预组未报告此类事件，这突出了精心的手术体位摆放以及对身体压力、温度、湿度和微气候的管理的有效性。结论 在神经外科公园长椅手术中实施预防措施可显著降低术后压力性损伤和皮肤疾病的发生率。这些发现主张在此类手术中采用标准化的体位固定方案，可能会影响全球神经外科临床实践。
