Lithotomy Position and Intraoperative-acquired Pressure Injury: A Prospective Observational Study

This prospective observational study aimed to determine the frequency of intraoperative-acquired pressure injuries (IAPIs) in the lithotomy position and identify contributing factors.

The study comprised a total of 218 patients aged 18 years and older who had scheduled urological surgery in the lithotomy position. The patients' skin conditions were assessed at 5 points: initially upon admission to the operating room; at the end of surgery; and then at 24, 48, and 72 hours after surgery for the development of IAPI.

The IAPI incidence was 26.1% at the end of surgery, and no IAPI was detected at any point between 24 and 72 hours postoperatively. The study revealed that 114 IAPIs were developed in 57 of 218 patients at the end of the surgery. It was established that all of the IAPIs observed in the patients were classified as stage 1. Of the 114 IAPIs that developed in patients, 27% were located in the posterior region of the right leg, and an equivalent proportion were located in the posterior region of the left leg. Age ( P = .009), alcohol use ( P = .042), comorbidities ( P = .040), diagnosis ( P = .015), and type of surgery ( P = .044) were associated with IAPI development. In multivariable analysis, age ( P = .002; odds ratio, 1.039; 95% CI, 1.01-1.07) and alcohol consumption ( P = .035; odds ratio, 6.741; 95% CI, 1.15-36.63) were associated with a higher risk of IAPI.

The incidence of IAPI was high in this sample. It is recommended that the posterior region of the legs be supported in patients scheduled to undergo surgery in the lithotomy position, given that all IAPIs occur in this region.