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Risk factors associated with pressure ulcers in the pediatric patient following open--heart surgery

J R Neidig, C Kleiber, R A Oppliger

    Progress in Cardiovascular Nursing
    |July 1, 1989
    PubMed

    Insights

    Pediatric open-heart surgery patients are at risk for scalp ulcers. A new protocol reduced ulcer incidence from 16.9% to 4.8% by minimizing pressure and shearing forces on the occipital region.

    Area of Science:

    • Pediatric Surgery
    • Critical Care Medicine
    • Wound Prevention

    Background:

    • Infants and children undergoing open-heart surgery face risks of postoperative complications.
    • Occipital pressure ulcers are a concern in pediatric intensive care unit (PICU) patients.

    Purpose of the Study:

    • To identify risk factors for occipital pressure ulcers in pediatric open-heart surgery survivors.
    • To evaluate the effectiveness of a new protocol in reducing ulcer incidence.

    Main Methods:

    • Retrospective chart audit of 59 pediatric patients post-open-heart surgery.
    • Identification of risk factors including age, congenital heart defect type, intubation duration, and PICU length of stay.
    • Implementation of a protocol to reduce occipital pressure and shearing forces.

    Main Results:

    • Pre-protocol: 16.9% of patients developed occipital ulcers.
    • Identified risk factors: patient age, congenital heart defect type, duration of mechanical ventilation, and PICU length of stay.
    • Post-protocol: Ulcer incidence decreased significantly to 4.8%.

    Conclusions:

    • Occipital pressure ulcers are a significant postoperative complication in pediatric open-heart surgery patients.
    • Age, congenital heart defect complexity, prolonged intubation, and extended PICU stay are key risk factors.
    • A targeted protocol effectively reduced the incidence of these pressure ulcers.

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