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OR Time and Sacral Pressure Injuries in Critically Ill Surgical Patients.

Mary Jo Grap, Christine M Schubert, Cindy L Munro

    AORN Journal
    |January 30, 2019
    PubMed
    Summary

    Critically ill patients may develop pressure injuries during surgery. Shorter operating room (OR) time, higher body mass index, and lower Braden Scale scores predict injury risk, suggesting early ultrasound assessment for prevention.

    Keywords:
    Braden ScaleOR timecritically ill surgical patientshigh frequency ultrasoundpressure injury

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    Area of Science:

    • Critical care medicine
    • Medical technology
    • Surgical nursing

    Background:

    • Critically ill patients face high risks of pressure injuries, especially during invasive procedures.
    • Early detection and prevention of pressure injuries are crucial in surgical settings.

    Purpose of the Study:

    • To investigate the association between operating room (OR) time and the development of sacral pressure injuries in critically ill patients.
    • To evaluate the utility of high-frequency ultrasound in assessing tissue changes related to pressure injury risk.

    Main Methods:

    • Secondary analysis of data from 41 critically ill patients.
    • Collected data included OR bed time and up to eight days of pressure injury assessment.
    • Utilized high-frequency ultrasound for tissue change evaluation.

    Main Results:

    • A multivariable model including OR bed time, body mass index (BMI), and Braden Scale score effectively predicted pressure injury (AUC = 0.859).
    • Higher BMI (P = .09), shorter OR bed time (P = .01), and lower Braden Scale score (P = .05) correlated with increased pressure injury risk.
    • High-frequency ultrasound may detect sub-clinical tissue alterations preceding visible skin damage.

    Conclusions:

    • Shorter OR bed time, higher BMI, and lower Braden Scale scores are significant predictors of pressure injury in critically ill patients.
    • High-frequency ultrasound shows promise for early identification of tissue changes, enabling proactive pressure injury prevention strategies.