Use of an Alternating Inflatable Head Pad inPatients Undergoing Open Heart Surgery

Abstract

BackgroundPreoperative symptoms like occipital pressure ulcers and alopecia areata (AA) significantly lowered patient quality of life. Therefore, preoperative nursing was in need of investigation. This study aimed to compare effects of an alternating inflatable head pad and a gel pad on occurrence of postoperative pressure ulcers and AA in patients undergoing open heart surgery.Material/MethodsThis was a prospective study. We allocated randomly 120 patients undergoing surgery (3–7 h) in the Yantai Yuhuangding Hospital affiliated to Qingdao University, China from January to October 2015 to the control (gel head pad) or the experimental (alternating inflatable head pad) group (n=60 per group). The incidence and severity of occipital pressure ulcer were graded by the classification system of the European Pressure Ulcer Advisory Panel (EPUAP). The degree of occipital alopecia was measured by hair pull test. This study used the t test and chi-square analysis. All statistics were analyzed by SPSS 21.0.ResultsCompared with the control group, there was a significantly lower incidence and severity of occipital pressure ulcer and alopecia in the experimental group (9 cases/60 cases vs. 1 case/60 cases, P<0.01). Moreover, multivariate analysis showed the risk of developing occipital pressure ulcer after surgery was also obviously lower in the experimental group (OR 1.449–120.798; P<0.005). Hair pull test revealed that fewer patients in the experimental group had a hair loss over 10%.ConclusionsThe alternating inflatable head pad was effective in reducing the incidence and severity of occipital pressure ulcer and alopecia associated with surgery, which benefited the postoperative nursing and improved patient quality of life.

Evaluation of a fluidised positioner to reduce occipital pressure injuries in intensive care patients: A pilot study

“…Studies on devices to assist in the prevention of occipital PIs are scarce. The few studies undertaken have included air pads, gel pads, or foam rings . Some occipital devices, particularly ring‐shaped or donut‐shaped devices that off‐load the centre of the occiput, have been found to cause more shear at the surface and internally, and in fact increase the risk for the development of PIs .…”

Headgear-induced temporary pressure alopecia

“…The majority of case reports of pressure alopecia have been observed following extended surgical procedures, giving rise to the alternative name of postoperative alopecia (Abel and Lewis, 1960; Bagaria and Luck, 2015; Chang et al, 2016; Domínguez-Auñón et al, 2004; Huang et al, 2018; Iwai et al, 2009; Lawson et al, 1976; Matsushita et al, 2011; Wiles and Hansen, 1985). Other causes of pressure alopecia reported in the literature include electroencephalogram electrodes (Kunapareddy et al, 2018; Morris et al, 1992), headbands (Sano et al, 2018), fixed head positioning while watching television (Thiem et al, 2016) and breakdancing (Bonifazi, 2006).…”

“…Lawson et al (1976) found that perioperative rotation of the head every 30 min reduced risk of pressure alopecia from 14% to 1%. A prospective study performed by Huang et al (2018) showed that using an alternating inflating head pad during open heart surgery significantly lowered incidence of postoperative alopecia compared to a conventional gel head pad.…”

Superfícies de suporte para prevenção de lesão por pressão no período intraoperatório: revisão sistemática com metanálise

“…Já no estudo de Nixon et al (1998), dos 65 pacientes com LPP, 56 (86%) apresentaram lesões classificadas em Grau 1 (hiperemia com branqueamento), quatro (6,2%) em Grau 2a (hiperemia sem branqueamento) e cinco (7,7%) em Grau 2b (dano superficial na epiderme). Porém, os autores utilizaram para o estadiamento das lesões uma escala modificada de Torrance, diferentemente dos demais estudos incluídos nesta revisão, nos quais as classificações empregadas foram pautadas na Discussão diretrizes da EPUAP e da National Pressure Ulcer Advisory Panel (NPUAP) vigentes na época da condução das pesquisas (HOSHOWSKY;SCHRAMM, 1994;ARONOVITCH et al, 1999;SCHULTZ et al, 1999;RUSSELL;LICHTENSTEIN, 2000;FEUCHTINGER et al, 2006;WU et al, 2011;ZHU;QU, 2018;JOSEPH et al, 2019;EZEAMUZIE et al, 2019).…”

“…6.2 Comparação entre as superfícies de suporte de alta tecnologia com as superfícies de baixa tecnologia Nesta categoria foram incluídos três ensaios clínicos randomizados (ARONOVITCH et al, 1999;RUSSEL;LICHTENSTEIN, 2000;ZHU;QU, 2018) e dois estudos não randomizados (EZEAMUZIE et al, 2019;JOSEPH et al, 2019), nos quais os autores testaram superfícies de suporte de alta tecnologia comparadas as superfícies de baixa tecnologia. Em um estudo primário, os estudiosos indicaram que para o grupo controle o cuidado padrão foi empregado, sem especificar o dispositivo utilizado (JOSEPH et al, 2019).…”