Prevalence of postoperative pressure ulcer: A systematic meta-analytic review

Abstract

IntroductionA pressure ulcer is a serious safety issue in healthcare systems. The patient’s rate of infection with an ulcer, especially a postoperative ulcer, is critical, as it is dictated by factors such as being in a fixed position during surgery, the type of anesthesia used, the duration of surgery, and patient-related factors. The present study was conducted to carry out a systematic assessment of the prevalence of a postoperative pressure ulcer and to find its general prevalence using a meta-analysis.MethodsThe researchers searched databases, including PubMed, Google Scholar, Scopus, Science Direct, the Thomson Reuters’ Web of Science (WOS). For English articles published online between January 2000 and October 2015 on the subject of a pressure ulcer, a total of 19 articles were ultimately selected based on the study inclusion criteria. Then results were analyzed in Stata-11.ResultsThe 19 articles qualified for entering the meta-analysis examined a total of 9527 patients. The studies estimated the general prevalence of a postoperative pressure ulcer as 18.96% (CI 95%: 15.3–22.6); the prevalence by gender was reported as 10.1% (CI 95%: 7.2–13.01) in men and 12.8% (CI 95%: 8.3–17.2) in women. Stage 1 ulcer had a 17.02% prevalence (CI 95%: 11.04–22.9), stage 2 a 6.7% prevalence (CI 95%: 3.8–9.7), stage 3 a 0.9% prevalence (CI 95%: 0.2–1.6), and stage 4 a 0.4% (CI 95%: −0.05–0.8) prevalence.ConclusionThe prevalence of a postoperative pressure ulcer is high among the entire population; however, it is still higher in women than in men. The prevalence of a stage 1 ulcer is higher than the prevalence of the other stages of an ulcer.

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

“…Our study found low BMI and low preoperative Braden score to be significant predictors of HAPU, which is consistent with other similar studies . However, there are also studies that identified the postoperative Braden score as a significant predictor of HAPU . Therefore, we performed an additional secondary analysis on the postoperative Braden score and found that it was also statistically significant in our univariate analysis.…”

“…7,12,21,24 However, there are also studies that identified the postoperative Braden score as a significant predictor of HAPU. 33,34,41 Therefore, we performed an additional secondary analysis on the postoperative Braden score and found that it was also statistically significant in our univariate analysis. However, we did not include it in our prediction model because we wanted to use variables that are available preoperatively to determine a patient's pressure ulcer risk.…”

“…Most studies found no difference between men and women 1,12,23,31-33 in the development of HAPU except for Hayes et al, 21 who concluded that men were more likely to • a prediction tool, called the surgical pressure ulcer score (SPURS), was developed using these eight significant factors to predict pressure ulcer risk, which can be used before the patient's operation develop pressure ulcers compared with women (65% vs 60%), and a recent systematic review has also agreed that the prevalence of postoperative pressure ulcers was higher in women than men (13% vs 10%). 34 The impact of a patient's comorbidities on development of HAPU is rather uncertain. For example, Lin et al 33 did not find diabetes to be associated with development of HAPU; however, this could be because of the relatively young population in their study (mean age: 48 years).…”

“…Another common risk factor associated with HAPU is gender. Most studies found no difference between men and women in the development of HAPU except for Hayes et al, who concluded that men were more likely to develop pressure ulcers compared with women (65% vs 60%), and a recent systematic review has also agreed that the prevalence of postoperative pressure ulcers was higher in women than men (13% vs 10%) …”

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

“…A better understanding of the risk factors for PI is essential as it may allow stratification of patients before surgery, and targeted prevention. Here, it was a surprise to find that sex was not associated with the development of PI, as a previous meta‐analysis has reported this. A large number of studies were included in the present meta‐analysis of sex, and it is unlikely that an increased risk could have been missed.…”