Intraoperative pressure injury and risk factors in long-term surgical interventions

Uzun süreli cerrahi girişimlerde ameliyat sırası basınç yaralanması ve risk faktörleri

Authors

DOI:

https://doi.org/10.14687/jhs.v19i3.6300

Keywords:

nursing, pressure injury, Surgery, intraoperative, risk factors, prevalence

Abstract

Background: If the operation time is 60 minutes or longer, the patient's risk of pressure injury increases.

Aim: This study aims to determine the prevalence and risk factors for intraoperatively acquired pressure injury (IAPI) in patients who underwent surgery for 60 ≥ minutes in a hospital in Turkey.

Methods: The research is a cross-sectional, descriptive, prospective design. Data were collected in the perioperative period (N=200). Sociodemographic and Clinical Characteristics Form and 3S intraoperative pressure injury risk assessment scale were used for data collection.

Findings: IAPI occurred in 18.0% of participants. In this study, there was a statistically significant correlation with women ([RR: relative risk]:1.242, 95%, CI [confidence interval]: 0.484-3.190)  at risk of pressure injury, those with chronic diseases and those who had major surgery (RR: 11.569, 95%, CI: 2.029-65.954). In addition, the patient's position during surgery posed a 2.6 times (95% CI: 0.552-12.674) risk for pressure injury.

Based on IRAS score, there was a significant relationship between the time of the operation (RR:2.051, 95% CI: 1.113-3.780), and the intraoperative stress (RR:4.338, 95% CI: 1.815-10.369) for the risk of pressure injury.

Conclusion: IAPI remains a significant problem in the operating room. In this study, according to sociodemographic characteristics, being female, having a history of chronic disease and being a candidate for major surgery may cause the intraoperative pressure injury. According to 3S- IRAS, long operative time and high skin stress score may create a significant risk of intraoperative pressure injury. Perioperative nurses should assess the risk of each surgical patient and provide position support for the patient during the surgical procedure.

Keywords: Surgery; pressure injury; intraoperative; risk factors; prevalence

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Author Biographies

Büşra İpek

M.Sc., The Liv Hospital Group

Yazile Sayın

Associate Professor Dr., University of Bezmialem, Faculty of Health Sciences, Nursing Department, Surgical Nursing Department

 

References

Akan, C. & Sayin, Y. (2021). Prevalence of pressure injuries and risk factors in long-term surgical procedures. Bezmialem Science, 9(1):75-83. DOI: 10.14235/bas.galenos.2020.3820

Armstrong, D. & Bortz, P. (2001). An integrative review of pressure relief in surgical patients. AORN Journal, 73, 645-674. DOI: 10.1016/s0001-2092(06)61960-1

Aronovitch, S. (1999). Intraoperatively acquired pressure ulcer prevalence: a national study. J Wound Ostomy Continence Nursing, 26, 130-136. DOI: 10.1016/s1071-5754(99)90030-x.

Bliss, M. & Simini, B. (1999). When are the seeds of postoperative pressure sores sown? often during surgery. BMJ, 319, 863-864. DOI: 10.1136/bmj.319.7214,863.

Chen, H., L., Chen, X., Y. & Wu, J. (2012). The incidence of pressure ulcers in surgical patients of the last 5 years: a systematic review. Wounds, 24, 234-241. https://www.ncbi.nlm.nih.gov/pubmed/25874704

Dalvand, S., Ebadi, A. & Gheshlagh, R., G. Nurses’ knowledge on pressure injury prevention: a systematic review and meta-analysis based on the pressure ulcer knowledge assessment tool. Clin Cosmet Investing Dermatologyl, 11, 613-620. DOI: 10.2147/CCID.S186381

Fred, C., Ford, S. & Wagner, D. (2012). Intraoperatively acquired pressure ulcers and perioperative normothermia: a look at relationships. AORN Journal, 96, 251-260. DOI: 10.1016/j.aorn.2012.06.014.

Fu Shaw, L., Chang, P., C., Lee, J., F., Kung, H., Y. & Tung, T., H. (2014). Incidence and predicted risk factors for pressure ulcers in surgical patients: experience at a medical center in Taipei, Taiwan. BioMed Research International, 2014, 416896. DOI: 10.1155/2014/416896.

Gao, X., L., Hu, J., J., Ma, Q., Wu, H., Wang, Z., Li, T. et al. (2015). Design and research on reliability-validity for 3S intraoperative risk assessment scale of pressure sore. Journal of Huazhong University of Science and Technology - Medical Science, 35, 291-294. DOI: 10.1007/s11596-015-1426-1.

Ganos D, Siddiqui A. Operating room. In Pieper B, ed, with the National Pressure Ulcer Advisory Panel (NPUAP). Pressure Ulcers: Prevalence, Incidence, and Implications for the Future. Washington, DC: NPUAP; 2012: 57-64.

Gül, Ş., & Karadağ A. (2015). Effect of fluid-filled support-surface utilization on prevention of pressure ulcers in the operating room: An experimental study. International Journal of Human Sciences. 2015:12(1): 328-342. https://www.j-humansciences.com/ojs/index.php/IJHS/article/download/2777/1419

He, W., Liu, P., Chen, H.L. (2012). The braden scale cannot be used alone for assessing pressure ulcer risk in surgical patients: a meta-analysis. Ostomy Wound Management, 58, 34–40. http://www.o-wm.com/content/braden-scale-cannot-be-used-alone-assessing-pressure-ulcer-risk-surgical-patients-meta-analy

Karayurt, O. & Celik, B. (2017). Pressure injuries caused by surgery and nursing care. Turkiye Klinikleri J Surg Nurs-Special Topics, 3, 176-182.

Kim, J.M., Lee, H., Ha, T., Na, S. (2018). Perioperative factors associated with pressure ulcer development after major surgery. Korean J Anesthesiology, 71, 48–56. DOI: 10.4097/kjae.2018.71.1.48

Konateke, S. (2021). An important risk to prevent in the operating room: pressure injury. Journal of Anatolia Nursing and Health Sciences, 24, 365-372 (in Turkish). DOI: https://doi.org/0.17049/ataunihem.902979

Lewicki, L., Mion, L., Splane, K., G., Samstag, D. & Secic, M. (1997). Patient risk factors for pressure ulcers during cardiac surgery. AORN Journal, 65, 933-942. DOI: 10.1016/s0001-2092(06)62976-1.

Lindholm, C., Sterner, E., Romanelli, M., Pina, E., Bou, J., T., Hietanen, H. et al. (2008). Hip fracture and pressure ulcers- the pan- european pressure ulcer study- intrinsic and extrinsic risk factors. Int Wound J, 5, 315-328. DOI: 10.1111/j.1742-481X.2008.00452.x.

Lumbley, J., L., Ali, S., A. & Tchokouani, L., S. (2014). Retrospective review of predisposing factors for intaraoperative pressure ulcer development. Journal of Clinical Anesthesia, 26, 368-374.

Munro, C., A. (2010). The development of a pressure ulcer risk-assessment scale for perioperative patients. AORN Journal, 92, 272-287. DOI: 10.1016/j.jclinane.2014.01.012

National Pressure Ulcer Advisory Panel. (2016). National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury. Washington. http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/. Accessed November 20, 2021.

O’Brien, D., D., Shanks A., M., Talsma, A., Brenner, P., S. & Ramachandran, S.,K. (2014). Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients: a retrospective observational study. Critical Care Medicine, 42, 40-47. DOI: 10.1097/CCM.0b013e318298a849.

Padula, W., Black, J., Davidson, P., Kang, S. & Pronovost, P. (2018). Adverse effects of the Medicare PSI-90 hospital penalty system on revenue-neutral hospital-acquired conditions. Journal of Patient Safety, 16, 97-102. DOI: 10.1097/PTS.0000000000000517

Papantonio, C., J., Wallop, J., M. & Kolodner K., B. (1994). Sacral ulcers following cardiac surgery: incidence and risks. Advanced Wound Care, 7, 24-36.

Park, S., Park, H. & Hwang, H. (2019). Development and comparison of predictive models for pressure injuries in surgical patients: a retrospective case–control study. J Wound Ostomy Continence Nursing, 46, 291-297. DOI: 10.1097/WON.0000000000000544.

Peixoto, C., A., Ferreira, M., B., G., Felix, M., M., D., S., Pires, P., S., Barichello, E. & Barbosa, M., H. (2019). Risk assessment for perioperative pressure injuries. Revista Latino-Americana de Enfermagem Revista, 27, 3117. DOI: 10.1590/1518-8345.2677-3117.

Primiano, M., Friend, M., McClure, C., Nardi, S., Fix, L., Schafer, M. et al. (2011). Pressure ulcer prevalence and risk factors during prolonged surgical procedures. AORN Journal, 94, 555-566. DOI: 10.1016/j.aorn.2011.03.014

Rao, A., D., Preston, A., M., Strauss, R., Stamm, R. & Zalman, D., C. (2016). Risk factors associated with pressure ulcer formation in critically ill cardiac surgery patients: a systematic review. Journal of Wound Ostomy & Continence Nursing, 43, 242-247. DOI: 10.1097/WON.0000000000000224.

Sanada, H., Nagakawa, T., Yamamoto, M., Higashidani, K., Tsuru, H. & Sugama, J. (1997). The role of skin blood flow in pressure ulcer development during surgery. Advances in Wound Care, 10, 29-34.

Soyer, Ö. & Özbayır, T. (2018). Turkish adaptation of the 3S intraoperatıve pressure ulcer risk assessment scale. International Refereed Journal of Nursing Studies, 13, 46–64 (in Turkish). DOI: 10.17371/UHD.2018.2.9

Spruce, L. (2016). Back to basics: preventing perioperative pressure injuries. AORN Journal, 105, 92-99. DOI: 10.1016/j.aorn.2016.10.018.

Tschannen, D., Bates, O., Talsma, A. & Guo, Y. (2012). Patient-specific and surgical characteristics in the development of pressure ulcers. American Journal of Critical Care, 21, 116-125. DOI: 10.4037/ajcc2012716.

Vermillion, C. (1990). Operating room acquired pressure ulcers. Decubitus, 3, 26-30.

Yılmaz, E. & Baslı, A., A. (2021). Assessment of Pressure Injuries Following Surgery: A Descriptive Study. Wound Management & Prevention, 67, 27-40. https://www.hmpgloballearningnetwork.com/site/wmp/empirical-studies/assessment-pressure-injuries-following-surgery-descriptive-study

Yoshimura, M., Lizaka, S., Kohno, M., Nagata, O., Yamasaki, T., Mae, T. et al. (2016). Risk factors associated with intraoperatively acquired pressure ulcers in the park-bench position: a retrospective study. International Wound Journal, 13, 1206-1213. DOI: 10.1111/iwj.12445.:

Webster, J., Lister, C., Corry, J., Hollanda, M., Coleman, K. & Marquart, I. (2015). Incidence and risk factors for surgically acquired pressure ulcers: a prospective cohort study investigators. J Wound Ostomy Continence Nurs, 42, 138-144. DOI: 10.1097/WON.00000000000000092.

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Published

2022-09-25

How to Cite

İpek, B., & Sayın, Y. (2022). Intraoperative pressure injury and risk factors in long-term surgical interventions: Uzun süreli cerrahi girişimlerde ameliyat sırası basınç yaralanması ve risk faktörleri. Journal of Human Sciences, 19(3), 474–487. https://doi.org/10.14687/jhs.v19i3.6300

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Section

Nursing and Midwifery