Risk factors associated with intraoperatively acquired pressure ulcers in the park-bench position: a retrospective study

Abstract

Patients undergoing surgery in the park-bench position are at high risk of developing intraoperatively acquired pressure ulcers (IAPUs). The purpose was to examine retrospectively risk factors associated with IAPUs in the park-bench position. This study was conducted at a general hospital during the period of September 2010 to September 2012. Twenty-one potential risk factors were evaluated using data obtained from the hospital database. IAPUs developed in 30 of 277 patients (11%). Perspiration was statistically found to be independently associated with IAPUs [OR 3·09, 95% confidence interval (Cl) 1.07-8·58, P = 0·037]. A length of surgery of more than 6 hours was identified to be likely associated with IAPUs (OR 2·64, 95% Cl 0·84-9·08, P = 0·095) compared with less than 6 hours. Furthermore, there was an interaction between the length of surgery and the core temperature; that is, when the length of surgery was more than 6 hours, a core temperature of more than 38·1°C at the end of surgery had a higher odds ratio (8·45, 95% Cl 3·04-27·46, P < 0·001) than that at a lower core temperature (3·20, 95% Cl 1·23-8·78, P = 0·017). These results suggest that perspiration and core temperature are preventable causative factors of pressure ulcers, even under conditions of prolonged surgery in the park-bench position.

Keywords: Core temperature; Perioperative nursing; Perspiration; Pressure ulcer prevention; Surgery.

© 2015 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Figures

Figure 1

Park‐bench position, The patient's head is clamped in a Mayfield frame, and the lateral trunk is fixed on the main operating table with the upside arm positioned along the lateral trunk and the downside arm fixed on an external arm board.

Figure 2

Flow of the participants throughout the study, 309 patients were enrolled. Excluding 31 patients, 277 patients were finally included in the analysis.

Figure 3

Relationship between the core temperature at the end of surgery and the incidence of pressure ulcers, The core temperature at the end of surgery was measured according to the rectal temperature at the end of surgery. The values below each range of core temperature show pressure ulcer incidence (%). The number of surgeries associated with pressure ulcers increased for a core temperature of more than 38·1°C at the end of surgery. No pressure ulcers developed at a core temperature of less than 37·1°C at the end of surgery.