| The Incidence Rate and Risk Factors of Pressure-induced Skin Breakdown during Operation. |
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Soo Joo Choi, Dae Won Kim, Hye Seon Chung, Hyun Joo Ahn, Mi Sook Gwak, Mikyung Yang, Sang Min Lee, Gaab Soo Kim |
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. gskim@smc.samsung.co.kr
2Department of Operating Room, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
Pressure-induced skin breakdown is not only a painful inconvenience to the patient, but it is also associated with a prolonged hospital stay. This study examined the incidence of pressure-induced skin breakdown in attempt to identify the associated risk factors during elective surgery.
METHODS
Data were collected from 808 subjects who underwent orthopedic, thoracic, neuro- or plastic surgery over a six-month period. The data included age, gender, weight, height, body mass index, ASA status, surgical position, operation time, estimated blood loss, preoperative hemoglobin concentration, serum albumin, co-morbidity, and intraoperative hypotension. The patient's skin was inspected closely within 24 hours after surgery. The sites and severity of skin breakdown were assessed.
RESULTS
Of the 808 patients in this study, 192 patients (23.8%) developed skin breakdown during surgery. The incidence of blisters, abrasion, or blister and abrasion was 6.1%. The patient's weight, operation time, estimated blood loss, malignancy, and intraoperative hypotension were significantly related to the development of skin breakdown (P < 0.05). The incidence of pressure-induced skin breakdown was highest in the prone position (P = 0.000). Age, gender, body mass index, hypertension, diabetes, preoperative hemoglobin and albumin level were not found to be risk factors of skin breakdown.
CONCLUSIONS
The early identification of a patient at risk is a first step in a scientifically based approach for preventing the development of pressure sores. Although intervention will not always prevent the development of pressure sores, a medical team must recognize the risk factors associated with skin breakdown and carry out careful intervention during the perioperative period. |
| Key Words:
operation; pressure; risk factor; skin breakdown |
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