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Bentsen SB, Eide GE, Wiig S, Rustøen T, Heen C, Bjøro B. Patient positioning on the operating table and patient safety: A systematic review and meta-analysis. J Adv Nurs 2024. [PMID: 38186052 DOI: 10.1111/jan.16049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
AIM To identify occurrence of harmful incidents related to patient positioning on operating table. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight databases including Ovid, Medline, Embase, CINAHL, the Cochrane Library, Epistemonikos, Scopus, Web of Science and Google Scholar were systematically searched from the inception of the databases to August 2023. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram depicting the flow information. REVIEW METHODS The Cochrane Risk of Bias Tools were used to assess the risk of bias. Risk of harm with 95% confidence interval (CI) was estimated for each included study, and an overall risk was calculated using meta-analysis. RESULTS Of the 22 included reports, two were randomized controlled trials (RCTs), five had a prospective cohort design, three had a cross-sectional design, and 12 were register-based studies. Intraoperative peripheral nerve injuries, perioperative pressure ulcers, musculoskeletal injuries, vascular injuries, postoperative pain and eye injuries were related to supine, lithotomy, Trendelenburg, prone and beach chair positioning. Overall risk of any harm was estimated as 0.2%. Studies with patients placed in prone positioning (8 study samples) had the highest risks of harm varying from 0.19 to 0.81, with an overall risk of 0.33. Meta-analysis of the two RCTs showed higher risk of chemosis with head-down positioning than with head in neutral position (overall relative risk = 1.64; 95% CI: [1.25, 2.14]). CONCLUSIONS Harmful incidents related to patient positioning occur and consequences can be severe. The operating room teams should be aware of the harms and prevent and treat them seriously. IMPACT This review underlines that research is sparse on patient positioning on operating table and harmful incidents. There is a need for high-quality, well-designed studies that focus on harmful incidents and prevention of harm related to patient positioning. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution, as this is a review of previous research.
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Affiliation(s)
- Signe Berit Bentsen
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Division of Emergencies and Critical Care, Department of Operating Services, Oslo University Hospital, Oslo, Norway
| | - Geir Egil Eide
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Siri Wiig
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- SHARE Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Tone Rustøen
- Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Cathrine Heen
- Division of Emergencies and Critical Care, Department of Operating Services, Oslo University Hospital, Oslo, Norway
| | - Benedikte Bjøro
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Department of Operating Services, Oslo University Hospital, Oslo, Norway
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Choi S, Kim YJ, Oh H, Yuh WT, Lee CH, Yang SH, Kim CH, Chung CK, Park HP. Factors Associated With Perioperative Hospital Acquired Pressure Injury in Patients Undergoing Spine Surgery in the Prone Position: A Prospective Observational Study. J Neurosurg Anesthesiol 2024; 36:45-52. [PMID: 36006663 DOI: 10.1097/ana.0000000000000867] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hospital acquired pressure injury (HAPI) is associated with poor clinical outcomes and high medical costs. Patients undergoing surgery in the prone position are particularly vulnerable to perioperative HAPI. This prospective observational study investigated the factors associated with HAPI in patients undergoing elective spine surgery in the prone position. METHODS Two hundred eighty-seven patients undergoing elective spine surgery participated in this study. Demographics, perioperative vital signs, laboratory findings, surgical data, and intraoperative data were prospectively recorded. The sites and stages of HAPI were investigated on postoperative day 2. The stages of HAPI were evaluated using the pressure injury staging system of the National Pressure Ulcer Advisory Panel. RESULTS Perioperative HAPI was observed in 71 (24.7%) patients (stage 1, 40; stage 2, 31). The most frequent site (number) of HAPI was the upper extremities (33), followed by the chest (32), lower extremities (20), face (18), pelvis (10), and abdomen (9). In multivariate analysis, the duration of prone positioning per hour (odds ratio [95% confidence interval], 1.48 [1.25-1.74]; P <0.001) and intraoperative pH ≤7.35 (1.98 [1.05-3.76]; P =0.036) were associated with perioperative HAPI. CONCLUSIONS The incidence of perioperative HAPI was 24.7% in patients undergoing elective spine surgery in the prone position. Long duration of prone positioning and intraoperative acidosis were associated with increased development of perioperative HAPI.
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Affiliation(s)
| | | | | | - Woon Tak Yuh
- Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chang-Hyun Lee
- Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Heon Yang
- Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chi Heon Kim
- Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chun Kee Chung
- Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Cai J, Jiang M, Qi H. Evaluating the Effects of a General Anesthesia and Prone Position Nursing Checklist and Training Course on Posterior Lumbar Surgery: A Randomized Controlled Trial. J Patient Saf 2024; 20:22-27. [PMID: 37921750 DOI: 10.1097/pts.0000000000001178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND While general anesthesia in the prone position is one of the most utilized surgical positions, it predisposes to multiple types of complications. Existing studies on this topic are mostly literature reviews or focus on solving one complication, which limits their clinical use. OBJECTIVE The aims of the study were to evaluate the effectiveness of a 22-item general anesthesia and prone position nursing checklist and specific training course at preventing complications related to general anesthesia in the prone position. DESIGN The study used a randomized controlled trial. SETTINGS AND PARTICIPANTS Convenience sampling was used to recruit patients who underwent general anesthesia during posterior lumbar surgery from July 2021 to December 2021 at the Run Run Shaw Hospital, Zhejiang University School of Medicine Hospital. METHODS Patients involved in the study were randomly assigned to the control (standard general anesthesia and prone position care) or experimental group (general anesthesia and prone position nursing checklist combined with specific training course in addition to standard general anesthesia and prone position care). Outcomes were pressure injuries, peripheral nerve injuries, ocular complications, and length of stay (LOS). Patient satisfaction, Numeric Pain Rating Scale (NRS) and the Oswestry Disability Scale were also measured. RESULTS Compared with the control group, pressure injury, brachial plexus injury, and two ocular findings (foreign body sensation and blurry vision) were significantly less common in the intervention group ( P ≤ 0.01). Participants who received standard general anesthesia and prone position care had lower self-reported satisfaction than those managed with the general anesthesia and prone position nursing checklist plus specific training course ( P = 0.002). The checklist-based intervention also significantly reduced LOS ( P = 0.000) and NRS ( P = 0.000). CONCLUSIONS The intervention group had significant fewer general anesthesia in the prone position-related complications, improved satisfaction, reduced LOS, and lower NRS. These findings suggest that a general anesthesia and prone position nursing checklist in addition to a specific training course are beneficial to standardizing prone position nursing care during posterior lumbar surgery.
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Affiliation(s)
- Jianshu Cai
- From the Nursing Department, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Desselle MR, Coyer F, Byram I, Fakhr R, Forrestal DP, Green N, Mason O, Wainwright L, Kirrane M. Safety and usability of proning pillows in intensive care: A scoping review. Aust Crit Care 2023; 36:847-854. [PMID: 37616086 DOI: 10.1016/j.aucc.2022.08.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Proning is an established technique for the care of intubated patients with severe respiratory failure. Positioning devices used to support the head and body of patients placed in the prone position are often associated with the formation of pressure injuries. Despite robust literature on the prevention and monitoring of pressure injuries, little is described about the role of proning pillows on pressure injuries. The objective of this review is to understand the extent of evidence pertaining to the safety and usability of different types of proning pillows in the intensive care setting. REVIEW METHOD A scoping review of the literature was completed using predefined search terms in three databases and identified 296 articles. An additional 26 were included from reference lists. Twenty studies are included in the analysis; most were published in the past 3 years, with >50% in surgical settings. DATA SOURCES Three databases were searched: PubMed, Scopus, and EMBASE. REVIEW METHODS The review followed the PRISMA Extension for Scoping Reviews, and data were reviewed using Covidence. RESULTS The most prevalent proning pillow is a standard, noncontoured foam head positioner. It is responsible for the majority of facial pressure injuries in all settings of care. Memory foam pillows and helmet-based systems offer improved surface pressure distribution, although their usability in the intensive care setting remains poorly studied. Inflatable air-cell-based devices present an alternative, but the lack of supporting research and the costs may explain their poor uptake. Several articles proposed the use of pressure sensor systems to evaluate devices. We propose a set of ergonomic parametres to consider when choosing or designing a positioning device for proned patients. CONCLUSION The evidence pertaining to the safety and usability of proning pillows in the intensive care setting is scarce, which provides opportunities for future research to improve the efficacy in the prevention of pressure injuries and the user experience.
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Affiliation(s)
- Mathilde R Desselle
- Herston Biofabrication Institute, Metro North Health, Herston QLD 4029 Australia; Faculty of Engineering, Queensland University of Technology, Brisbane QLD 4000 Australia; School of Medicine, The University of Queensland, Herston QLD 4006 Australia.
| | - Fiona Coyer
- Intensive Care Services, Royal Brisbane and Women's Hospital, Herston QLD 4029 Australia; School of Nursing, Queensland University of Technology, Kelvin Grove QLD 4059 Australia
| | - Isabel Byram
- Herston Biofabrication Institute, Metro North Health, Herston QLD 4029 Australia
| | - Roozbeh Fakhr
- Herston Biofabrication Institute, Metro North Health, Herston QLD 4029 Australia; Faculty of Creative Industries, Education and Social Justice, Queensland University of Technology, Kelvin Grove QLD 4059 Australia
| | - David P Forrestal
- Herston Biofabrication Institute, Metro North Health, Herston QLD 4029 Australia; School of Mechanical and Mining Engineering, The University of Queensland, St Lucia QLD 4067 Australia
| | - Nicholas Green
- Herston Biofabrication Institute, Metro North Health, Herston QLD 4029 Australia
| | - Oliver Mason
- Rehabilitation Engineering Centre, Surgical Treatment and Rehabilitation Services, Herston QLD 4029 Australia
| | - Luke Wainwright
- Clinical Skills Development Service, Herston QLD 4029 Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia QLD 4072 Australia
| | - Marianne Kirrane
- School of Medicine, The University of Queensland, Herston QLD 4006 Australia; Intensive Care Services, Royal Brisbane and Women's Hospital, Herston QLD 4029 Australia
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Asadi K, Fouladpour A, Ghorbani Vajargah P, Mollaei A, Firooz M, Hosseini SJ, Zaboli Mahdiabadi M, Samidoust P, Takasi P, Karkhah S, Salari A, Aris A. Prevalence of pressure ulcer and related factors in orthopaedic wards: A systematic review and meta-analysis. Int Wound J 2023; 20:2914-2923. [PMID: 36960790 PMCID: PMC10410314 DOI: 10.1111/iwj.14156] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
The aim of this systematic review and meta-analysis is to provide an overview of the prevalence of pressure ulcers (PU) in orthopaedic wards. A comprehensive, systematic search was conducted in different international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database (SID) using keywords extracted from Medical Subject Headings such as "Prevalence", "Pressure ulcer", "Pressure sore", and "Orthopaedics" from the earliest to February 1, 2023. The appraisal tool for cross-sectional studies (AXIS tool) evaluates the quality of the included studies. Finally, 11 studies were included in the final analysis. The results indicated that the prevalence of PU in orthopaedic departments was 18% (ES: 0.18, 95% CI: 0.10-0.26, Z = 4.53, I2 : 99.09%). Although the odds ratio of PU was lower in men than women, it was not statistically significant (OR: 0.91, 95% CI: 0.74-1.11, Z = 0.95, I2 : 17.4%, P = .34). Also, results showed the prevalence of PU was higher among studies with a sample size of more than 200 (ES: 0.19, 95% CI: 0.10-0.28, Z = 4.07, I2 : 99.1%), Europe region (ES: 0.20, 95% CI: 0.14-0.26, Z = 6.7, I2 : 93.0%) and prospective design (ES: 0.23, 95% CI: 0.18-0.27, Z = 9.47, I2 : 83.3%) when compared with other sub-groups. In sum, considering the 18% prevalence of PU in the orthopaedic department, it is recommended to focus on detecting risk factors and design interventions to reduce PU in the patients admitted orthopaedic department.
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Affiliation(s)
- Kamran Asadi
- Department of Orthopedics, Orthopedic Research Center, Poorsina Hospital, Faculty of MedicineGuilan University of Medical SciencesRashtIran
| | - Amin Fouladpour
- Department of Orthopedics, Orthopedic Research Center, Poorsina Hospital, Faculty of MedicineGuilan University of Medical SciencesRashtIran
| | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | | | - Pirouz Samidoust
- Razi Clinical Research Development UnitRazi Hospital, Guilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amir Salari
- Department of Orthopedics, Orthopedic Research Center, Poorsina Hospital, Faculty of MedicineGuilan University of Medical SciencesRashtIran
| | - Arash Aris
- Department of Orthopedics, Orthopedic Research Center, Poorsina Hospital, Faculty of MedicineGuilan University of Medical SciencesRashtIran
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Garg B, Bansal T, Mehta N, Sharan AD. Patient Positioning in Spine Surgery: What Spine Surgeons Should Know? Asian Spine J 2023; 17:770-781. [PMID: 37226380 PMCID: PMC10460667 DOI: 10.31616/asj.2022.0320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 09/15/2022] [Indexed: 05/26/2023] Open
Abstract
Spine surgery has advanced tremendously over the last decade. The number of spine surgeries performed each year has also been increasing constantly. Unfortunately, the reporting of position-related complications in spine surgery has also been steadily increasing. These complications not only result in significant morbidity for the patient but also raises the risk of litigation for the surgical and anesthetic teams. Fortunately, most position-related complications are avoidable with basic positioning knowledge. Hence, it is critical to be cautious and take all necessary precautions to avoid position-related complications. We discuss the various position-related complications associated with the prone position, which is the most commonly used position in spine surgery, in this narrative review. We also discuss the various methods for avoiding complications. Furthermore, we briefly discuss less commonly used positions in spine surgery, like the lateral and sitting positions.
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Affiliation(s)
- Bhavuk Garg
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi,
India
| | - Tungish Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi,
India
| | - Nishank Mehta
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi,
India
| | - Alok D. Sharan
- Spine and Orthopedics, NJ Spine and Wellness, Matawan, NJ,
USA
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Li N, Cui D, Shan L, Li H, Feng X, Zeng H, Li L. The prediction model for intraoperatively acquired pressure injuries in orthopedics based on the new risk factors: a real-world prospective observational, cross-sectional study. Front Physiol 2023; 14:1170564. [PMID: 37546531 PMCID: PMC10401272 DOI: 10.3389/fphys.2023.1170564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/05/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction: Orthopedic patients are at high risk for intraoperatively acquired pressure injuries (IAPI), which cause a serious issue and lead to high-expense burden in patient care. However, there are currently no clinically available scales or models to assess IAPI associated with orthopedic surgery. Methods: In this real-world, prospective observational, cross-sectional study, we identified pressure injuries (PI)-related risk factors using a systematic review approach and clinical practice experience. We then prepared a real-world cohort to identify and confirm risk factors using multiple modalities. We successfully identified new risk factors while constructing a predictive model for PI in orthopedic surgery. Results: We included 28 orthopedic intraoperative PI risk factors from previous studies and clinical practice. A total of 422 real-world cases were also included, and three independent risk factors-preoperative limb activity, intraoperative wetting of the compressed tissue, and duration of surgery-were successfully identified using chi-squared tests and logistic regression. Finally, the three independent risk factors were successfully used to construct a nomogram clinical prediction model with good predictive validity (area under the ROC curve = 0.77), which is expected to benefit clinical patients. Conclusion: In conclusion, we successfully identified new independent risk factors for IAPI-related injury in orthopedic patients and developed a clinical prediction model to serve as an important complement to existing scales and provide additional benefits to patients. Our study also suggests that a single measure is not sufficient for the prevention of IAPI in orthopedic surgery patients and that a combination of measures may be required for the effective prevention of IAPI.
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Affiliation(s)
- Ning Li
- Department of Anesthesia and Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Dalei Cui
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Li Shan
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Haixia Li
- Department of Anesthesia and Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Xuelian Feng
- Department of Anesthesia and Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Huilan Zeng
- Department of Anesthesia and Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China
| | - Lezhi Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Gokce Isikli A, Kızılcık Özkan Z. Retrospective evaluation of the effectiveness of using two different products in preventing the development of pressure injuries in patients undergoing lung lobectomy. J Tissue Viability 2023; 32:163-167. [PMID: 36351868 DOI: 10.1016/j.jtv.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/12/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
AIM This retrospective study aims to determine the impacts of two different products (barrier cream, barrier spray) routinely used before surgery on the development of postoperative pressure injuries in patients undergoing lung lobectomy. MATERIALS AND METHODS In the study, the researchers retrospectively examined the data of 60 patients who underwent lobectomy in a university hospital's thoracic surgery clinic between 12.02.2021 and 14.02.2022. The patients were divided into two groups: those to whom a barrier cream was applied (30) and those to whom a barrier spray was applied. The Patient Description Form and the Braden Risk Assessment Tool were used in data collection. The Mann-Whitney U and Kruskal-Wallis tests were conducted for statistical analyses. RESULTS In the study, the development rates of blanchable erythema and stage I pressure injuries in the sacral and dorsal regions were significantly higher in patients to whom a barrier spray was applied than in patients to whom a barrier cream was applied (p < 0.05). Pain intensity in the sacral and dorsal regions was significantly lower in patients to whom a barrier cream was applied than those to whom a barrier spray was applied (p < 0.05). CONCLUSION Blanchable erythema and intraoperative pressure injury were observed less in patients in whom a barrier cream was used before surgery. Surgical nurses should first evaluate the risk in the preoperative period in the clinics and benefit from the use of barrier cream to prevent the development of blanchable erythema and intraoperative pressure injury.
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Affiliation(s)
- Ayse Gokce Isikli
- Thoracic Surgery, Health Research and Application Center, Trakya University, Edirne, Turkey.
| | - Zeynep Kızılcık Özkan
- Department of Surgical Nursing, Faculty of Health Sciences, Trakya University, Edirne, Turkey.
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Matsuoka R, Shin Y, Tei R, Wada E, Motoyama Y. A Case of Concomitant Lip Injury and Facial Pressure Ulcer in Lumbar Intradural Tumor Surgery With Repeated Transcranial Electrical Stimulations. Cureus 2022; 14:e31560. [DOI: 10.7759/cureus.31560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
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Facial Pressure Ulcers: Unsightly Complication of Prone Positioning. Anesthesiology 2022; 136:827-828. [PMID: 35286391 DOI: 10.1097/aln.0000000000004188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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