| Pressure sore is a kind of bed sore that forms several hours or within 6 days after the surgery. Patients who go through long surgery are in a very high risk of getting pressure sore. The external factors like the pressure, friction and humidity and internal factors like nutrition and age could affect the incidence of pressure sore as well as some special risks in the operating room. It is a big problem to analyze these risk factors and to adopt effective methods to prevent pressure sore.Objective:To analyze the cause and risk factors of pressure ulcer and to provide evidence for the prevention and protection from pressure ulcer by investigating the basic information of patients, related index and the incidence of postural pressure ulcer in the surgery.Methods:One hundred and ninety four patients who underwent surgery in prone position during the time of Jun. 2007 to Apr. 2008 in the operation room of a hospital in Changchun are the objects with descriptive study in this research. Of these patients 70 emergency cases were due to traumatic spinal fracture and dislocation and 124 selective cases were due to hernia of intervertebral discs and spinal deformity. The patients were visited by scrub nurses before the surgery and their basic information was recorded. The information of the patients before, during and after the surgery was recorded, too. We observed and recorded the skin condition in compression as well as the condition of the skin before, on the day and 6 days after of the surgery. All the data was recorded in Excel database and treated with SPSS 13.0 statistics software.Results:(1) Of all these 194 patients 60 (31%) got congestion in the compressed skin. There were 18 cases in all that had fast erythema in compressed skin for two days which were diagnosed as stage I pressure ulcer. In these 18 cases, the numbers of patients who got pressure ulcer in the surgery day, the first day, the second and the third day after the surgery were 12, 4, 1 and 1 with a percentage of 66% that got pressure ulcer of stage I in the surgery day, of three of whom developed from stage I to stage II in the 2nd day.(2) History of diabetes mellitus, smoking and pressure ulcer has relation with the appearance of pressure ulcer (P <0.05). There is statistics significance in the variation of pressure ulcer incidence with blood sugar, serum total protein and serum albumin level before the surgery (P <0.05).(3) There is statistics significance in the variation of pressure ulcer incidence with surgery time and anesthesia time (P <0.05).(4) Post surgery analgesia has no correlation with formation of pressure ulcer. There is no statistics significance in the variation of pressure ulcer incidence with fasting time and body temperature (P >0.05).(5) Unconditional Logistic regression analysis was performed due to 24 viarable factors and showed that history of diabetes mellitus was definitely a risk factor of pressure sore (OR=17.33, P=0.003) and so did it with anesthesia lasting time (OR=3.70, P=0.023); the protecting factors were serum total protein (OR=0.01, P=0.001).Conclusions:(1) The incidence of pressure ulcer for patients in prone position is 9.28%, of which stage I is 83.33%. The compressed parts are in a very high risk to get sore. Pressure ulcer usually comes out from the surgery day to the first day after surgery which is the key time for the prevention.(2) History of diabetes mellitus, smoking, pressure ulcer, the level of total protein and albumin, surgery time and anesthesia lasting time concern with the formation of pressure ulcer. DM history and anesthesia lasting time are the risk factors in pressure ulcer formation while serum total protein level is the protective factor.(3)The nutritional condition of the patient has a lot to do with pressure ulcer formation. There should be a full-scale evaluation and intervention of the patients'nutrition and condition and good control of the blood sugar level before the surgery and close monitor during the surgery.
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