Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study
Yıl: 2022 Cilt: 14 Sayı: 2 Sayfa Aralığı: 296 - 303 Metin Dili: İngilizce DOI: 10.5336/nurses.2021-84832 İndeks Tarihi: 10-07-2022
Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study
Öz: Objective: This study aimed to determine the incidence
and risk factors of perioperative pressure injury (PI) in surgical patients.
Material and Methods: This descriptive, prospective, and comparative
study was conducted with 101 patients who underwent general surgery
in a training and research hospital in İstanbul between September 2018
and June 2019. Data were collected using the “Patient Data Form,” the
“Braden Scale,” and the “International Pressure Injury Classification
System.” Data were analyzed with parametric and nonparametric tests
using the SPSS package program. The statistical significance level was
taken as p<0.05. The necessary institutional and ethics committee permission was obtained to conduct the study. Results: In this study, it was
observed that the incidence of perioperative PI was 12.9% (13/101) in
surgical patients, and most developed after pancreaticoduodenectomy
(38.5%). Preoperative hemoglobin and serum albumin levels, surgical
time longer than 185 minutes, and intraoperative hypotensive episodes
were found to be determinant risk factors in the development of PI
(p<0.01). Conclusion: Surgical nurses should carefully evaluate individual and surgery-related risk factors and implement evidence-based
interventions in the prevention of pressure injuries.
Anahtar Kelime: Cerrahi Hastalarında Perioperatif Basınç Yaralanması İnsidansının ve Risk Faktörlerinin Belirlenmesi: Tanımlayıcı, İleriye Yönelik ve Karşılaştırmalı Bir Çalışma
Öz: Amaç: Bu çalışmanın amacı, cerrahi hastalarında perioperatif
basınç yaralanması insidansını ve risk faktörlerini belirlemektir. Gereç ve
Yöntemler: Bu tanımlayıcı prospektif ve karşılaştırmalı çalışma, Eylül
2018-Haziran 2019 tarihleri arasında İstanbul’da bir eğitim ve araştırma
hastanesinde genel cerrahi uygulanan 101 hasta ile gerçekleştirildi. Veriler “Hasta Veri Formu,” “Braden Ölçeği” ve “Uluslararası Basınç
Yaralanması Sınıflandırma Sistemi” kullanılarak toplandı. Veriler, SPSS
paket programı kullanılarak parametrik ve parametrik olmayan testler ile
değerlendirildi. İstatistiksel anlamlılık düzeyi p<0,05 olarak alındı.
Araştırmanın gerçekleştirilebilmesi için gerekli kurum ve etik kurul izinleri alındı. Bulgular: Bu çalışmada, cerrahi hastalarında perioperatif
basınç yaralanması insidansının %12,9 (13/101) olduğu ve en çok
pankreatikoduodenektomi sonrası (%38,5) geliştiği görüldü. Perioperatif
basınç yaralanması gelişiminde belirleyici risk faktörlerinin; ameliyat
öncesi hemoglobin ve serum albumin düzeyleri, ameliyat süresi (≥185
dk) ve intraoperatif hipotansif atakların olduğu belirlendi (p<0,01).
Sonuç: Cerrahi hemşireleri, perioperatif basınç yaralanmalarının önlenmesinde bireysel ve cerrahi ile ilişkili risk faktörleri dikkatli bir şekilde
değerlendirmeli ve kanıta dayalı girişimleri uygulamalıdır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Chen HL, Chen XY, Wu J. The incidence of pressure ulcers in surgical patients of the last 5 years: a systematic review. Wounds. 2012;24(9):234-41. [PubMed]
- 2. Celik B, Karayurt Ö, Ogce F. The effect of selected risk factors on perioperative pressure injury development. AORN J. 2019;110(1):29-38. [Crossref] [PubMed]
- 3. Haisley M, Sørensen JA, Sollie M. Postoperative pressure injuries in adults having surgery under general anaesthesia: systematic review of perioperative risk factors. Br J Surg. 2020;107(4):338-47. [Crossref] [PubMed]
- 4. European Pressure ulcer Advisory Panel (EPuAP) [Internet]. [Date of access: 5 August 2020]. National Pressure ulcer Advisory Panel (NPuAP), Pan Pacific Pressure Injury Alliance (PPPIA). Prevention and Treatment of Pressure ulcers: Quick Reference Guide. Perth, Australia: Cambridge Media; 2014. Access link: [Link]
- 5. Primiano M, Friend M, McClure C, Nardi S, Fix L, Schafer M, et al. Pressure ulcer prevalence and risk factors during prolonged surgical procedures. AORN J. 2011;94(6):555-66. [Crossref] [PubMed] [PMC]
- 6. Riemenschneider KJ. Prevention of pressure injuries in the operating room: A quality improvement project. J Wound Ostomy Continence Nurs. 2018;45(2):141-5. [Crossref] [PubMed]
- 7. O'Brien DD, Shanks AM, Talsma A, Brenner PS, Ramachandran SK. Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients: a retrospective observational study. Crit Care Med. 2014;42(1):40-7. [Crossref] [PubMed]
- 8. Chen Y, He L, Qu W, Zhang C. Predictors of intraoperative pressure injury in patients undergoing major hepatobiliary surgery. J Wound Ostomy Continence Nurs. 2017;44(5):445-9. [Crossref] [PubMed]
- 9. Gao L, Yang L, Li X, Chen J, Du J, Bai X, et al. The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer. J Clin Nurs. 2018;27(15-16):2984-92. [Crossref] [PubMed]
- 10. Bulfone G, Marzoli I, Quattrin R, Fabbro C, Palese A. A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres. J Perioper Pract. 2012;22(2):50-6. Erratum in: J Perioper Pract. 2012;22(4):111. [Crossref] [PubMed]
- 11. Lumbley JL, Ali SA, Tchokouani LS. Retrospective review of predisposing factors for intraoperative pressure ulcer development. J Clin Anesth. 2014;26(5):368-74. [Crossref] [PubMed]
- 12. Engels D, Austin M, McNichol L, Fencl J, Gupta S, Kazi H. Pressure ulcers: Factors contributing to their development in the OR. AORN J. 2016;103(3):271-81. [Crossref] [PubMed]
- 13. Karadag M, Gümüskaya N. The incidence of pressure ulcers in surgical patients: a sample hospital in Turkey. J Clin Nurs. 2006;15(4):413-21. [Crossref] [PubMed]
- 14. Kim JM, Lee H, Ha T, Na S. Perioperative factors associated with pressure ulcer development after major surgery. Korean J Anesthesiol. 2018;71(1):48-56. [Crossref] [PubMed] [PMC]
- 15. Shaw LF, Chang PC, Lee JF, Kung HY, Tung TH. Incidence and predicted risk factors of pressure ulcers in surgical patients: experience at a medical center in Taipei, Taiwan. Biomed Res Int. 2014;2014:416896. [Crossref] [PubMed] [PMC]
- 16. Aloweni F, Ang SY, Fook-Chong S, Agus N, Yong P, Goh MM, et al. A prediction tool for hospital-acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score. Int Wound J. 2019;16(1):164-75. [Crossref] [PubMed] [PMC]
- 17. Bergstrom N, Braden BJ, Laguzza A, Holman v. The braden scale for predicting pressure sore risk. Nurs Res. 1987;36(4):205-10. [Crossref] [PubMed]
- 18. Pınar R, Oğuz S. Norton ve Braden bası yarası değerlendirme ölçeklerinin yatağa bağımlı aynı hasta grubunda güvenirlik ve geçerliğinin sınanması: uluslararası Katılımlı vI. ulusal Hemşirelik Kongresi, Kongre Kitabı; 1998. p.172-5.
- 19. Connor T, Sledge JA, Bryant-Wiersema L, Stamm L, Potter P. Identification of pre-operative and intra-operative variables predictive of pressure ulcer development in patients undergoing urologic surgical procedures. urol Nurs. 2010;30(5):289-95, 305. [Crossref] [PubMed]
- 20. Wright KM, van Netten Y, Dorrington CA, Hoffman GR. Pressure injury can occur in patients undergoing prolonged head and neck surgery. J Oral Maxillofac Surg. 2014;72(10):2060-5. [Crossref] [PubMed]
- 21. Peixoto CA, Ferreira MBG, Felix MMDS, Pires PDS, Barichello E, Barbosa MH. Risk assessment for perioperative pressure injuries. Rev Lat Am Enfermagem. 2019;27:e3117. [Crossref] [PubMed] [PMC]
- 22. Nixon J, Cranny G, Bond S. Skin alterations of intact skin and risk factors associated with pressure ulcer development in surgical patients: a cohort study. Int J Nurs Stud. 2007;44(5):655-63. [Crossref] [PubMed]
- 23. Fernandes LM, Silva L, Oliveira JLC, Souza vS, Nicola AL. Association between pressure injury prediction and biochemical markers. Rev Rene. 2016;17(4):490-7. [Crossref]
- 24. van Stijn MF, Korkic-Halilovic I, Bakker MS, van der Ploeg T, van Leeuwen PA, Houdijk AP. Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review. JPEN J Parenter Enteral Nutr. 2013;37(1):37-43. [Crossref] [PubMed]
- 25. Mistrík E, Dusilová-Sulková S, Bláha v, Sobotka L. Plasma albumin levels correlate with decreased microcirculation and the development of skin defects in hemodialyzed patients. Nutrition. 2010;26(9):880-5. [Crossref] [PubMed]
- 26. Chello C, Lusini M, Schilirò D, Greco SM, Barbato R, Nenna A. Pressure ulcers in cardiac surgery: Few clinical studies, difficult risk assessment, and profound clinical implications. Int Wound J. 2019;16(1):9-12. [Crossref] [PubMed] [PMC]
- 27. Huang W, Zhu Y, Qu H. use of an alternating inflatable head pad inpatients undergoing open heart surgery. Med Sci Monit. 2018;24:970-6. [Crossref] [PubMed] [PMC]
| APA | KANDEMIR D, temiz z, AYDIN A, YAYLA F, ÖZHANLI Y, Ayoglu T (2022). Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. , 296 - 303. 10.5336/nurses.2021-84832 |
| Chicago | KANDEMIR Didem,temiz zeynep,AYDIN ATİYE,YAYLA FATMA,ÖZHANLI YASEMİN,Ayoglu Tuluha Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. (2022): 296 - 303. 10.5336/nurses.2021-84832 |
| MLA | KANDEMIR Didem,temiz zeynep,AYDIN ATİYE,YAYLA FATMA,ÖZHANLI YASEMİN,Ayoglu Tuluha Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. , 2022, ss.296 - 303. 10.5336/nurses.2021-84832 |
| AMA | KANDEMIR D,temiz z,AYDIN A,YAYLA F,ÖZHANLI Y,Ayoglu T Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. . 2022; 296 - 303. 10.5336/nurses.2021-84832 |
| Vancouver | KANDEMIR D,temiz z,AYDIN A,YAYLA F,ÖZHANLI Y,Ayoglu T Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. . 2022; 296 - 303. 10.5336/nurses.2021-84832 |
| IEEE | KANDEMIR D,temiz z,AYDIN A,YAYLA F,ÖZHANLI Y,Ayoglu T "Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study." , ss.296 - 303, 2022. 10.5336/nurses.2021-84832 |
| ISNAD | KANDEMIR, Didem vd. "Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study". (2022), 296-303. https://doi.org/10.5336/nurses.2021-84832 |
| APA | KANDEMIR D, temiz z, AYDIN A, YAYLA F, ÖZHANLI Y, Ayoglu T (2022). Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 14(2), 296 - 303. 10.5336/nurses.2021-84832 |
| Chicago | KANDEMIR Didem,temiz zeynep,AYDIN ATİYE,YAYLA FATMA,ÖZHANLI YASEMİN,Ayoglu Tuluha Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi 14, no.2 (2022): 296 - 303. 10.5336/nurses.2021-84832 |
| MLA | KANDEMIR Didem,temiz zeynep,AYDIN ATİYE,YAYLA FATMA,ÖZHANLI YASEMİN,Ayoglu Tuluha Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, vol.14, no.2, 2022, ss.296 - 303. 10.5336/nurses.2021-84832 |
| AMA | KANDEMIR D,temiz z,AYDIN A,YAYLA F,ÖZHANLI Y,Ayoglu T Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2022; 14(2): 296 - 303. 10.5336/nurses.2021-84832 |
| Vancouver | KANDEMIR D,temiz z,AYDIN A,YAYLA F,ÖZHANLI Y,Ayoglu T Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi. 2022; 14(2): 296 - 303. 10.5336/nurses.2021-84832 |
| IEEE | KANDEMIR D,temiz z,AYDIN A,YAYLA F,ÖZHANLI Y,Ayoglu T "Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study." Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 14, ss.296 - 303, 2022. 10.5336/nurses.2021-84832 |
| ISNAD | KANDEMIR, Didem vd. "Determination of Incidence and Risk Factors of Perioperative Pressure Injury in Surgical Patients: A Descriptive, Prospective, and Comparative Study". Türkiye Klinikleri Hemşirelik Bilimleri Dergisi 14/2 (2022), 296-303. https://doi.org/10.5336/nurses.2021-84832 |
