Pressure Injury Can Occur in Patients Undergoing Prolonged Head and Neck Surgery

Wright, Kathleen M.; Netten, Yvonne Van; Dorrington, Carol A.; Hoffman, Gary R.

doi:10.1016/j.joms.2014.04.018

Cited by 16 publications

(27 citation statements)

References 6 publications

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“…In Fred et al, it was reported that a 1‐point increase in ASA grade increased the odds of a pressure ulcer by 149% . In contrast, Lin et al and Wright et al did not find ASA grade to be significant, but their studied population was younger (mean age between 47 and 55 years) and only underwent spinal or head and neck surgery, whereas our study included all types of surgery (except day surgery and cardiac cases), and our sample population's mean age was 70 years.…”

Section: Discussionmentioning

confidence: 68%

“…The evidence on gender and ASA grade among the published papers on HAPU in surgical patients was inconsistent. 7,12,21,25,26 Only a few studies have reported using ASA grade to predict a patient's risk of developing pressure ulcer postoperatively. 7,21,23,26 ASA grade is used to assess a patient's "sickness" or "physical state" before surgery; the higher the ASA grade, the more ill the patient.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies agreed that pressure ulcers occurred commonly in older patients, but only Wright et al found decreasing age to be associated with HAPU; however, Wright's study had a much smaller sample size (N = 88), and hence, it may be under‐powered to detect statistical significance. There were also studies that did not find older age to be significantly associated with HAPU, but their study population's mean age was between 48 and 58 years.…”

Section: Introductionmentioning

confidence: 99%

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A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Aloweni

Ang

Fook‐Chong

et al. 2018

International Wound Journal

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Surgical patients are prone to developing hospital‐acquired pressure ulcers (HAPU). Therefore, a better prediction tool is needed to predict risk using preoperative data. This study aimed to determine, from previously published HAPU risk factors, which factors are significant among our surgical population and to develop a prediction tool that identifies pressure ulcer risk before the operation. A literature review was first performed to elicit all the published HAPU risk factors before conducting a retrospective case‐control study using medical records. The known HAPU risks were compared between patients with HAPU and without HAPU who underwent operations during the same period (July 2015‐December 2016). A total of 80 HAPU cases and 189 controls were analysed. Multivariate logistic regression analyses identified eight significant risk factors: age ≥ 75 years, female gender, American Society of Anaesthesiologists ≥ 3, body mass index < 23, preoperative Braden score ≤ 14, anaemia, respiratory disease, and hypertension. The model had bootstrap‐corrected c‐statistic 0.78 indicating good discrimination. A cut‐off score of ≥6 is strongly predictive, with a positive predictive value of 73.2% (confidence interval [CI]: 59.7%‐84.2%) and a negative predictive value of 80.7% (CI: 74.3%‐86.1%). SPURS contributes to the preoperative identification of pressure ulcer risk that could help nurses implement preventive measures earlier.

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Section: Discussionmentioning

confidence: 68%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Aloweni

Ang

Fook‐Chong

et al. 2018

International Wound Journal

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“…Two studies 24,27 did not report on the comparability of the patient groups. Four studies 22,26,29,30 did not report on the completeness of data and any loss to follow-up.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Postoperative pressure injuries in adults having surgery under general anaesthesia: systematic review of perioperative risk factors

Haisley

Sørensen

Sollie

2020

British Journal of Surgery

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Background Pressure injuries (PIs) after surgery affect thousands of people worldwide. Their management is expensive, a cost that can be reduced with proper preventive measures. Patients having surgery under general anaesthesia are at risk of developing PI, yet no specific tool has been developed to assess the risk in these patients. This review aimed to summarize the published data on perioperative risk factors associated with the development of PI in adults having surgery under general anaesthesia. Methods All studies reporting on risk factors associated with the development of PI were included. Data were extracted from all articles and meta‐analysis was performed when three or more studies reported on a specific variable. Results The analysis identified five factors significantly associated with the development of PIs: cardiovascular disease, respiratory disease, diabetes mellitus, low haemoglobin level and longer duration of surgery. Factors not associated included serum albumin concentration, use of vasopressors during surgery, use of corticosteroids, sex and age. Conclusion Cardiovascular disease, respiratory disease, diabetes mellitus, anaemia and duration of surgery should be taken into consideration when trying to identify surgical patients at high risk of developing PIs. These factors could be used to predict PIs after surgery.

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“…According to Lupe et al, 15 the incidence of pressure ulcers in the postsurgery period ranges from 20.6% to 34.2%. One study found that 14% of patients with prolonged head and neck surgery developed pressure injuries 16 . Given that free flap procedures can easily exceed 10 hours, it is easy to see the need for nursing interventions to protect the skin integrity of this patient population.…”

Section: Procedures Overviewmentioning

confidence: 99%

Free Flap Procedures for Reconstruction After Head and Neck Cancer

Kini¹

2015

AORN Journal

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Patients with head and neck cancer are seeking improved surgical procedures to avoid severe defects that result from head and neck cancer resection. Free flap reconstruction provides vascularized tissue that has been transferred from a distant donor site on a patient's body to a recipient site, markedly improving wound closure and protecting structures of the head and neck. This article discusses free flap procedures for reconstruction after head and neck cancer resection, including the following procedure phases: airway protection and neck dissections, tumor resection, flap harvest, microvascular anastomosis of the flap, and reconstruction and closure. The article also explains specific risk factors for patients undergoing free flap procedures that have been identified in the literature and include procedure length, hypothermia, and pressure injuries. Each of these factors is discussed regarding its specific effect on this patient population, and the nursing interventions to reduce these risks are identified.

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Pressure Injury Can Occur in Patients Undergoing Prolonged Head and Neck Surgery

Cited by 16 publications

References 6 publications

A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score

Postoperative pressure injuries in adults having surgery under general anaesthesia: systematic review of perioperative risk factors

Free Flap Procedures for Reconstruction After Head and Neck Cancer

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