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Intraoperatively acquired pressure ulcer prevalence: a national study
1Albany Medical Center, NY, USA.
Objective:
This study was completed to determine the prevalence and identify comorbid conditions for intraoperatively acquired pressure ulcers.
Design:
A multisite, descriptive study was conducted.
Setting And Subjects:
A multisite sample population of patients from 33 of 50 states undergoing a surgical procedure of at least 3 hours' duration was studied.
Instruments:
A Hospital Background Data Form and a Patient Data Form were constructed to collect demographic data and information pertinent to surgically acquired pressure ulcerations. The Weighted Index Comorbidity Scale was incorporated into the Patient Data Form.
Methods:
Institutional and patient data forms were mailed to 1543 members of WOCN who practiced in an acute care facility. Each member was asked to collect data on those patients who had surgeries of 3 hours or longer during a period of 1 week.
Main Outcome Measures:
Patient and facility characteristics, visual observations of the patient's skin over a 72-hour period after surgery, and the Weighted Index Comorbidity Scale were used to determine the prevalence of surgically acquired pressure ulcers and the presence of relevant comorbid conditions.
Results:
An analysis of 104 returned facility surveys including 1128 patients was completed. The prevalence of pressure ulceration among this group was 8.5%. Forty percent of those surveyed underwent a procedure lasting approximately 3 hours and 33% underwent surgery lasting more than 5 hours. As the length of surgery increased, so did the percentage of patients with pressure ulcers. Most patients had at least 1 comorbid condition (78%).
Conclusions:
The risk of intraoperative ulcerations increases as surgical time increases. Although patients with comorbid conditions known to affect the risk of ulceration under normal circumstances experienced pressure ulcers in this investigation, no significant relationship was found to link the presence of these conditions to an increased risk of intraoperatively acquired ulcers. Therefore all surgical patients undergoing prolonged procedures should be considered at risk for intraoperative ulceration.