The Risk Factors Of Pressure Ulcer In The Forced Lateral And Prone Position In The Operation And Study On The Prevention Of Pressure Sores

ObjectiveThis study was to explore the effects of Sanyrene and Decompression stickers to prevent the intraoperative pressure ulcers of the patients who take the prone or lateral position during surgery;to explore the risk factors for pressure ulcers of the patients who take the prone or lateral position during surgery,which will help to improve the pressure prevention and treatment effects.Method:This study was a randomized controlled trial.Eight-hundred patients undergoing elective surgery were selected from April 1,2016 to January 31,2017 in tertiary general hospital which numbering by random number table,the experimental group and the control group with 400 cases in each group.According to the Waterlow risk factors assessment table,the risk factors of surgical patients with pressure ulcer were established,and the general data of the patients were investigated.The control group was treated with pressure relief,and the experimental group was treated with pressure reducing paste and skin moistening,The skin condition of the compression site was assessed within 30 minutes after the operation or at postoperative 24 hours,the number of cases of transformation or outcome of no pressure ulcer,stage,and find high risk factors of pressure ulcer in surgical patients.The general data of the respondents were described by frequency and percentage.All data using the Chinese version of the Excel2007 input,establish a database and check the validity of the scale.SPSS 21.0 was used to statistical analysis.Chi-square test were used to compare the control group and experimental group differences in the incidence of pressure ulcers.Using Logistic regression analysis to explore the risk factors of pressure ulcers occur.P<0.05 showed which had statistically significant.Results:1.In this study,a total of 800 patients with lateral position and prone position were collected.In the control group including 400 patients,305(76%)in the lateral position,95(24%)in the prone position,there were 16(4%)patients with pressure ulcer which ofen occurs in the lower jaw,zygomatic keel,anterior superior iliac spine and Ilium,Among them,11(69%)patients of which Erythema of 5(31%)patients disappeard in 24 hours after surgery and 6(37.5%)cases appeared blisters then turn to pressure ulcer in ? period were I period and 5(31%)patients were ?period.In the trial group including 400 patients309(77%)in the lateral position,91(23%)in the prone position),there were 6(1.5%)patients with pressure ulcer which ofen occurs in the mandibular,zygomatic ridge and skin abnormalities in which 2 cases were in ? period occurred in the 30 minutes after surgery and back to normal.2.The incidence of pressure ulcer was lower than that of the control group by single factor analysis(P<0.05).it is effective to use of skin care and Decompression stickers to prevent Intraoperative pressure sores.3.BMI,preoperative hemoglobin and operation time is the risk of patients with surgical pressure ulcers through the multivariate logistic regression analysis,the above factors were assigned to the unconditional multi-factor analysis.Body mass index ?17.5(OR=9.114)or ? 27(OR=11.185)is a risk factor for pressure ulcers.the occurrence of pressure ulcers were differrent in Preoperative hemoglobin<60g/L(OR=42.909),60-90 g/L(OR=11.903),90-110 g/L(OR=8.859)by cantrast to>110 g/L.Preoperative hemoglobin<110g is a risk factor for pressure ulcers and The lower the hemoglobin is in Preoperative,the greater the likelihood of pressure ulcers occurs.Operation time in 3-5h(OR=32.418)and>5h(OR=40.314)relative to 1-3h,had impact on pressure ulcer occurring,indicating that the operation time which is greater than 3h is the risk factors of pressure ulcers,and the longer the operation time,The greater the likelihood of a pressure ulcer occurs.Conclusions:Results showed that ulcers is likely to occur in bone juga,and usually occurred on the day to 24hours of surgery.Body pressure point of surgery is the high incidence of pressure ulcers.The experimental group which used Sanyrene combination of pressure relief could reduce the incidence of pressure ulcers compared to the control group which treated with pressure relief.Operation time,preoperative level of hemoglobin and BMI were main factors of pressure ulcers occurance.BMI?27 or ?17.5,operating time greater than 3h,preoperative level of hemoglobin is lower than 110g/L,which were main risk factors of pressure ulcers occurance.