A pressure care survey in the operating theatres

During 1988 and 1989 several patients developed severe pressure areas post operation. The patients all underwent major surgery lasting a few hours and experienced haemodynamic complications as a result of their condition in the peri-operative period. Although these pressure areas did not develop while the patients were in the operating theatres it was thought that the duration of their surgery contributed to the problem. In order to determine the extent of pressure area development on patients undergoing surgery it was decided to undertake an extensive quality assurance audit over a 3 month period. The sample of 108 patients included patients from cardiothoracic, orthopaedic and plastic microvascular, ear, nose and throat, ophthalmology, vascular, urology and general surgery plus a control group of patients whose surgery was less than 1 h duration. The patients were visited pre-operatively to assess their skin integrity. Intra-operative pressure care management plus other relevant information was documented. A second visit at 24 h post operation determined whether any changes in skin integrity had developed. The results of the surgery were not significant when the whole sample was looked at. However, they did become statistically significant when broken down into specialty groups. The recommendations of the survey included research into the improvement of operating table mattresses and contoured positioning devices. An education programme of staff was to be undertaken to develop greater awareness of the problem.