Uzamış Cerrahi İşlemlerde Basınç Yaralanması Prevelansı ve Risk Faktörleri

Abstract

Surgical Pressure Ulcers (PUS) on patients during surgery is one of the major problems that negatively affects the expected outcomes after surgery. The aim of the study is to determine the risk factors and prevalence condition of pressure ulcers due to long surgeries, and to draw attention to the responsibility of the surgery and the operating room nurse in the prevention of PUS. The research is a cross-functional descriptive study. The research covers the follow-up of patients from who underwent surgery in orthopedics, general surgery services between February 2017 and May 2018 in the operating room of Bezmialem Vakıf University Hospital. For the universe, the patients of these two clinics who underwent a major surgical intervention for the last year were targeted. In this case, according to the power analysis of the sample number of 170 consisted of individuals with a extensive voluntary surgical intervention planned. Ethical Committee for Research and written permission from institutions and volunteers from where the research was made was obtained. The data were collected with the Braden Risk assessment form, the patient diagnostic form based on the literature and analyzed with the number, percentage, average, standard deviation, t test, Ki Square tests in the SPSS 15.0 package program. The average age of the participants was 47.72 ± 22.20, % 55.9 was female and 44.1% was male. Preoperative data shows that 67.7% of the patients had a normal BMI between 18.5-24.9, 48.2% had no chronic disease, 97% were conscious, 98.8% had no dehydration, only 47.7% had no need for additional nutritional support, 87.6% 's hemoglobinemia level was between 13.6-17.7 g/dl and albumin was between 3.5- 5.5 g/dl, the pulse of 93,5% and the blood pressure of 76.5%, and the body temperature of 99% were between normal limits. 81.8% of participants underwent surgery in the supine position during surgery, the average duration of the surgery was 246.707±145.3 minutes. No special tissue support material was used in the pressure areas due to the position given during the operation on any of the participants. Support for pressure zones was provided only with mattresses, compressive and sheets. According to the first postoperative evaluation, PUS was developed in 24.1% of patients. In the development of PUS, it was determined that statistical rather the patient needed nutritional support, low albumin level, prolonged operation time, decreased Braden scale score played an important part statistically significant role (p<0.05). According to the data, it is important that the surgical nurse's preoperative risk diagnosis is performed for the prevention of PUS. In the prevention of PUS, a skin diagnosis of low albumin and nutritional problems, such as "pressure ulcers risk score", which includes objective and subjective data, should be shared with the operating room nurse. For long surgeries, it is recommended to use special tissue support materials (such as smart pets) for the PUS counterpressure zones.