Relationship between predisposing and facilitating factors: Does it influence the risk of developing peri‐operative pressure injuries?

Abstract

This study examined the relationship between the personal predisposing factors of patients and the severity of pressure injuries (PIs) developed during surgery. This retrospective cohort study collected 439 cases of peri‐operative PIs. Using binary logistic regression to identify the variables associated with PI severity, the effects of interactions between associated variables were then tested. The results of this study revealed that among the personal predisposing factors, only higher patient age (P = .001) and higher body mass index (P < .001) posed a greater risk of stage 2 PIs or higher. Among the surgery‐related facilitating factors, only patients who were placed in the prone position during surgery and patients who lost ≥1000 mL of blood during surgery were at greater risk of stage 2 PIs or higher, compared, respectively, to those placed in the supine position and those who lost ≤100 mL of blood. Furthermore, the amount of blood lost during surgery moderated the influence of age on PI severity. For elderly patients who are expected to lose a large blood volume during surgery or lose an immeasurable amount of blood due to the use of cardiopulmonary bypass, taking more precautionary measures to prevent PIs is recommended.

Impact of shear stress on sacral pressure injury from table rotation during laparoscopic colorectal surgery performed in the lithotomy position

“…Considering that the same positioning devices are used in all surgeries, we assume that this bias may reflect differences in the orientation and tilt of the patient’s body axis that occur when using positioning devices or that are caused by the patient’s body balance. Generally, the nutritional status, a history of diabetes mellitus, a high body mass index, prolonged surgery, and massive blood loss are considered risk factors for surgery-related PI 2 , 29 , 30 . The present study examined results of these previous studies using an index reflecting nutritional and body mass indexes in detail.…”

The paradox of obesity in pressure ulcers of critically ill patients

“…Obesity has many localised effects on pressure load. Although extra subcutaneous fat can provide better subcutaneous cushioning, reduce the degree of local tissue deformation, and prevent the occurrence of pressure ulcers, greater weight leads to an increase in pressure load and increases the risk of pressure ulcers 22 . Biomechanical modelling shows that with an increase in BMI, the protective effect of fat on tissue deformation is gradually offset by the increased pressure load caused by higher body weight, and the risk of pressure ulcers gradually increases 23 .…”

“…Although extra subcutaneous fat can provide better subcutaneous cushioning, reduce the degree of local tissue deformation, and prevent the occurrence of pressure ulcers, greater weight leads to an increase in pressure load and increases the risk of pressure ulcers. 22 Biomechanical modelling shows that with an increase in BMI, the protective effect of fat on tissue deformation is gradually offset by the increased pressure load caused by higher body weight, and the risk of pressure ulcers gradually increases. 23 The large body weight of obese patients, especially morbidly obese patients, creates greater local stress and makes turning care extremely difficult, though this is mitigated to some extent by adequate medical staffing in the ICU.…”

Extrinsic factors of pressure injuries in patients during surgery: A frequency matched retrospective study

“…The study is a sub‐project of a large‐scale research project; some of the results have already been published 31 . Data collection began after gaining approval from the institutional review board, Office of Human Research at Taipei Medical University—Joint Institutional Review Board (Approval Number: N202106059).…”