Pressure Ulcers Incidence in a Perioperative Neurosurgical Setting

Abstract

Background. Pressure ulcer is a major burden in surgical patients, increasing the length of hospital stay and the healing process, possibly leading to infectious complications and higher health care costs. In current literature there is no consensus on which element is mainly responsible for the onset of these lesions neither the role of surgery has been clarified. Methods. We collected a case series of consecutive admitted patients to Cattinara Hospital Neurosurgery Department in Trieste from March 2019 to June 2019. All the patients were assessed for surgery related pressure ulcer (SRPU) risk using the Pressure Score Risk Assessment Scale modified by Scotts. Epidemiologic data of all patients were recorded and the incidence of surgical related pressure ulcer calculated. The sample consisted of 124 patients with an average hospitalization length of 12.45 days; 71.8% of the enrolled patients were elective surgery patients, 5.5% emergency surgery and 22.6% urgency surgery. Comorbidity data were collected for each patient and surgical related time procedures noted.Results. The calculated incidence rate of surgery related pressure ulcer in a single center perioperative neurosurgical setting was 4.8%; the average surgery duration time was 213 minutes (mean ± 81 standard deviation, SD) whilst four out of six of these patients were admitted to intensive care unit due to unstable clinical conditions (average ICU stay time: 2.83 days; mean ± 4.99 standard deviation, SD). Time to SRPU onset was 6.83 days (mean ± 3.66 standard deviation, SD). The main site of SRPU onset was sacrum (66% of patients with developed SRPU). Discussion. This study evaluates single-center incidence of SRPU in neurosurgical perioperative setting with specifically SRPU management trained healthcare providers; deeper and systematic understanding of SRPU epidemiology in other local hospital wards and multi-centered comparison are needed.