Pressure Injury Risk Assessment and the Use of Intraoperative Polyurethane Foams to Prevent the Pressure Injuries
DOI:
https://doi.org/10.3889/oamjms.2022.8257Keywords:
Munro scale, Polyurethane foams, Pressure injury, SurgeryAbstract
BACKGROUND: Patients undergoing surgery are at risk of developing pressure sores up to 72 h after surgery. The incidence of pressure injury can affect patient outcomes and quality of care. Pressure injuries have many risk factors and causes. The Munro Pressure Ulcer Risk Assessment Scale for Perioperative Patients was used to assess risk factors for developing a pressure injury. One of the interventions to prevent pressure injuries during and after surgery is polyurethane foams.
AIM: The study aimed to describe the risk of pre-operative pressure injury, the use of intraoperative polyurethane foams, and the incidence of post-operative pressure injury in a private hospital in western Indonesia.
METHODS: A cross-sectional quantitative descriptive study was conducted among 81 patients undergoing surgery using purposive sampling. The pre-operative risk assessment was conducted with the Munro scale for the pre-operative phase. The use of polyurethane foams during surgery and pressure injury incidence was observed.
RESULTS: The results showed that 62 (76.5%) respondents were at moderate risk for pressure injury. 42 (51.9%) respondents used polyurethane foams in the intraoperative phase. Based on observation 72 h postoperatively, there was no pressure injury incidence.
CONCLUSION: Pressure injuries can be prevented by identifying risk factors before the surgery. Nurses and surgeons need to be aware of the risk of pressure ulcers in the pre-, inter-, and post-operative phases. The use of polyurethane foams during surgery can be considered an intervention to prevent pressure injury.Downloads
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Smith S, Snyder A, McMahon L Jr., Petersen L, Meddings J. Success in hospital-acquired pressure ulcer prevention: A tale in two data sets. Health Aff (Millwood). 2018;37(11):1787-96. https://doi.org/10.1377/hlthaff.2018.0712 PMid:30395514 DOI: https://doi.org/10.1377/hlthaff.2018.0712
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline; 2019.
Coleman S, Nixon J, Keen J, Wilson L, McGinnis E, Dealey C, et al. A new pressure ulcer conceptual framework. J Adv Nurs. 2014;70(10):2222-34. https://doi.org/10.1111/jan.12405 PMid:24684197 DOI: https://doi.org/10.1111/jan.12405
McKenzie RJ, Ramirez C. Preventing Pressure Injuries in the Operating Room. In: Pressure Injuries: Prevention Across the Acute-care Continuum; 2018. Available from: https://americannursetoday.mydigitalpublication.com/publication/?m=41491&i=492685&p=1&ver=html5. [Last accessed on 2021 Jul 12].
Peixoto CA, Ferreira MB, Felix MM, Pires P, Barichello E, Barbosa MH. Risk assessment for perioperative pressure injuries. Rev Latin Am Enferm. 2019;27:e3117. https://doi.org/10.1590/1518-8345.2677-3117 PMid:30698218 DOI: https://doi.org/10.1590/1518-8345.2677-3117
Kirkland-Walsh H, Teleten O, Wilson M, Raingruber B. Pressure mapping comparison of four OR surfaces. AORN J. 2015;102(1):61.e1-619. https://.doi.org/10.1016%2Fj.aorn.2015.05.012 PMid:26119617 DOI: https://doi.org/10.1016/j.aorn.2015.05.012
Joseph J, McLaughlin D, Darian V, Hayes L, Siddiqui A. Alternating pressure overlay for prevention of intraoperative pressure injury. J Wound Ostomy Continence Nurs. 2019;46(1):13-7. https://doi.org/10.1097/WON.0000000000000497 PMid:30601427 DOI: https://doi.org/10.1097/WON.0000000000000497
Powers J, Ames C. Take Action to Solve Causes of Pressure Injuries. In: Pressure Injuries: Prevention Across the Acute-care Continuum; 2018. Available from: https://americannursetoday.mydigitalpublication.com/publication/?m=41491&i=492685&p=1&ver=html5. [Last accessed on 2021 Jul 12].
Gao L, Yang L, Li X, Chen J, Du J, Yang H. Risk factors for intraoperative pressure ulcers in surgical patients. Int J Clin Exp Med. 2018;11(7):7429-35. http://www.ijcem.com/files/ijcem0075226.pdf PMid:30375697
Munro AC. The development of a pressure ulcer risk-assessment scale for perioperative patients. AORN J. 2010;92(3):272-87. https://doi.org/10.1016/j.aorn.2009.09.035 PMid:20816101 DOI: https://doi.org/10.1016/j.aorn.2009.09.035
Li D, Tang J, Gan X. Reliability and validity of the Munro scale on the assessment of pressure ulcer risks in adult perioperative patients: A cross-sectional study. Int J Clin Exp Med. 2018;11(9):9811-8. http://www.ijcem.com/files/ijcem0065427.pdf
The Polyurethane Foam Association. Viscoelastic (Memory) Foam. Tennessee: The Polyurethane Foam Association; 2016. In-Touch. Available from: https://www.pfa.org/wp-content/uploads/2019/02/InTouch_v11.1.pdf. [Last accessed on 2021 Jul 12].
Lenche N, Katerina D, Nikolchev A, Lidija P, Biljana PZ, Milenko K. The influence of comorbidity on the prevalence of pressure ulcers in geriatric patients. Glob Dermatol. 2016;3(3):319-22. https://doi.org/10.15761/god.1000183 DOI: https://doi.org/10.15761/GOD.1000183
Guo Y, Zhao K, Zhao T, Li Y, Yu Y, Kuang W. The effectiveness of curvilinear supine position on the incidence of pressure injuries and interface pressure among surgical patients. J Tissue Viability. 2019;28(2):81-6. https://doi.org/10.1016/j.jtv.2019.02.005 PMid:30878174 DOI: https://doi.org/10.1016/j.jtv.2019.02.005
Primiano M, Friend M, McClure C, Nardi S, Fix L, Schafer M, et al. Pressure ulcer prevalence and risk factors among prolonged surgical procedures in the OR. AORN J. 2015;94(6):555-6. https://doi.org/10.1016/j.aorn.2011.03.014 PMid:22118201 DOI: https://doi.org/10.1016/j.aorn.2011.03.014
Chiari P, Forni C, Guberti M. Predictive factors for pressure ulcers in an older adult population hospitalized for hip fractures: A prognostic cohort study. PLoS One. 2017;12(1):e0169909. https://doi.org/10.1371/journal.pone.0169909 PMid:28068425 DOI: https://doi.org/10.1371/journal.pone.0169909
Kirman NC. Pressure Injuries (Pressure Ulcers) and Wound Care; 2020. Available from: https://emedicine.medscape.com/article/190115-overview. [Last accessed on 2021 Jul 12].
Riyadi ME, Hanafi AI, Arningsih NK. Mobility ability and the degree of pressure sores in hospitalized patients. Health Sci Pharm J. 2020;4(1):28. https://doi.org/10.32504/hspj.v4i1.177 DOI: https://doi.org/10.32504/hspj.v4i1.177
Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018;18(1):305. https://doi.org/10.1186/s12877-018-0997-7 PMid:30537947 DOI: https://doi.org/10.1186/s12877-018-0997-7
Poitras V, Frey N. Polyurethane Foams Dressing for the Prevention Pressure Ulcers: Clinical and Cost-effectiveness and Guidelines. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017. Available from: https://europepmc.org/article/nbk/nbk470692. [Last accessed on 2021 Jul 12].
Yang YT, Shin HS. Effect of Soft Silicone Foams Dressings on Intraoperatively Acquired Pressure Injuries: A Randomized Study in Patients Undergoing Spinal Surgery. NIH; 2017.
Shen WQ, Chen HL, Xu YH. The relationship between length of surgery and the incidence of pressure ulcers in cardiovascular surgical patients: A retrospective study. Wound Care J. 2015;28(10):444-50. https://doi.org/10.1097/01.ASW.0000466365.90534.b0 PMid:26375947 DOI: https://doi.org/10.1097/01.ASW.0000466365.90534.b0
Bulfone G, Marzoli I, Quattri R. A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres. J Perioper Pract. 2012;22(2):50-6. https://doi.org/10.1177/175045891202200202 PMid:22724304 DOI: https://doi.org/10.1177/175045891202200202
Huang L, Woo KY, Liu L, Wen R, Hu A, Shi C. Dressing for preventing pressure ulcers: A meta-analysis. Adv Skin Wound Care. 2015;28(6):267-73. https://doi.org/10.1097/01.ASW.0000463905.69998.0d PMid:25988736 DOI: https://doi.org/10.1097/01.ASW.0000463905.69998.0d
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Copyright (c) 2022 Anitawati Panggabean, Ariea Muliea, Marisa Manik, Swingly Wikliv Dumanauw (Author)
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