A randomized controlled trial to compare the interface pressures of alternating pressure overlay with gel pad versus gel pad alone during prolonged surgery

Neo, Tze Guan; Koo, Seok Hwee; Chew, Samuel Teong Huang; Png, Gek Kheng; Lacuesta, Mary Jojie; Wu, Margie Ya Lan; Tay, Ramona Yu Ching; Singh, Prit Anand; Chandran, Rajkumar

doi:10.1016/j.jtv.2021.02.003

Cited by 6 publications

(15 citation statements)

References 40 publications

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“…The use of pressure‐relieving mattress decreased IAPI incidence in cardiac surgery by redistributing sacrococcygeal pressure through the alternate deflation of air pouches 6 . Besides, the alternating pressure gel mattress has been found to be able to reduce the interface pressure, thus lowering the risk of PI development 18 . Position changes, that is, repositioning, refers to the movement of patient body.…”

Section: Discussionmentioning

confidence: 99%

Effect of “micromovement” in preventing intraoperative acquired pressure injuries among patients undergoing surgery in supine position

Jin,

Liu,

Shentu

et al. 2023

International Wound Journal

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To explore the clinical effect of “micromovement” in preventing intraoperative acquired pressure injures (IAPIs) among patients experiencing surgery in supine position. A total of 200 patients accepting elective surgery in supine position from 10 May 2023 to 4 July 2023 at Shulan (Hangzhou) Hospital were selected and randomized into two groups (experimental group, n = 100; control group, n = 100). For control group patients, soft silicone foam dressing was applied to the sacrococcygeal region. On the basis of the treatment for control group patients, “micromovement” was implemented among experimental group patients. During this process, the operating table was tilted for 15° leftwards and rightwards alternately every 1 h, and the tilt angle was maintained for 5 min to prevent IAPIs. Finally, comparisons between the two groups were made in terms of the sacrococcygeal IAPI incidence, relative temperature differences (ΔT) on sacrococcygeal skin, and job satisfaction of nurses. Compared with control group patients, patients from the experimental group exhibited lower IAPI incidence (2% vs. 10%), reduced ΔT between the sacrococcygeal skin and surrounding normal skin [0 (−0.1, 0.1) vs. 0.2 (−0.2, 0.4)], and elevated job satisfaction of nurses (80% vs. 66%). All the differences were statistically significant (p < 0.05). “Micromovement” implemented intraoperatively among patients receiving surgery in supine position is able to lower the IAPI incidence by five times and elevate job satisfaction of nurses.

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Section: Discussionmentioning

confidence: 99%

Effect of “micromovement” in preventing intraoperative acquired pressure injuries among patients undergoing surgery in supine position

Jin,

Liu,

Shentu

et al. 2023

International Wound Journal

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“…The use of multilayered prophylactic silicone dressings on critically ill patients in intensive care units has prevented development of pressure injuries 31,32 . Alternating pressure distribution overlays on OR beds may be effective in helping prevent pressure injuries during long procedures 14,33,34 . AORN recommends that perioperative nurses apply prophylactic dressings on areas of the body that are at risk for development of pressure injury and position patients on OR bed surfaces that redistribute pressure 28…”

Section: Discussionmentioning

confidence: 99%

“…31,32 Alternating pressure distribution overlays on OR beds may be effective in helping prevent pressure injuries during long procedures. 14,33,34 AORN recommends that perioperative nurses apply prophylactic dressings on areas of the body that are at risk for development of pressure injury and position patients on OR bed surfaces that redistribute pressure. 28 Our study results also showed that the scapulae and the interscapular area experienced high tissue interface pressures during surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Factors influencing the peak tissue interface pressure during surgery include the patient’s weight, physical manipulation and positioning requiring application of external pressure, and the use of stabilizing devices 13 . The lengths of surgery and anesthesia 13 and the inability to reposition the patient to relieve pressure 14 determine the duration of pressure. A patient’s skin microclimate (ie, temperature, humidity, airflow near the patient or support surface), 15 age, 13 immobility during procedures, 13,16 intraoperative hypotensive episodes leading to low perfusion and tissue hypoxia, 16 decreased sensation, 15 low serum albumin levels (<3 to 3.5 g/dL), 17 and comorbidities 15 affect the tissue’s tolerance to pressure.…”

Section: Literature Reviewmentioning

confidence: 99%

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Using Continuous Intraoperative Pressure Mapping to Describe Patterns of Tissue Interface Pressure

Al-Majid¹,

Vuncanon²,

Kiyohara³

et al. 2022

AORN Journal

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The purpose of this study was to describe patterns of intraoperative tissue interface pressure, identify the amount of time during which the pressure at four anatomical locations exceeded 32 mm Hg, and examine associations between patient‐ and surgery‐related variables and peak tissue interface pressure. We used a pressure mapping system to measure the intraoperative tissue interface pressure of 150 patients. We implemented linear mixed‐effects models to assess trends in the mean and peak tissue interface pressure. The percentage of time during which the interface pressure exceeded 32 mm Hg at the scapulae, interscapular area, and sacral area was 70%, 70%, and 90%, respectively. Body mass index, length of surgery, and intraoperative position were major predictors of increased pressure. Understanding patterns of tissue interface pressure of patients during surgery may help perioperative nurses develop strategies to attenuate pressure and protect skin integrity.

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“…Our neurosurgery operating room nursing team has developed a fluidized positioner placement method in lateral and prone positions after discussion and practice, and all have received standardized training and assessment prior to placement. Gel pads are routinely used for skin protection in a variety of postures and provide good skin protection, 11 and have been widely used in most hospitals. This research will compare the intraoperative skin protection outcomes of applying between fluidized positioners and gel pads for lateral and prone neurosurgery at our hospital from 2018 to 2021.…”

Section: Introductionmentioning

confidence: 99%

The comparison of fluidized positioners and traditional gel pads for skin protection in neurosurgical patients undergoing lateral and prone positions: A retrospective analysis with propensity score matching method

Zeng,

Tian,

Gong

et al. 2024

International Wound Journal

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To compare fluidized positioners and gel pads for skin protection in neurosurgery patients placed in lateral and prone positions. It is one of the major challenges that operating room nurses face in protecting the skin during the long duration of neurosurgery. Currently, there are increasing tools available to protect the skin under pressure, and various tools practice well in the clinic. Fluidized positioners are newly emerging protective pads that have been clinically effective in protecting the skin, but no studies have compared them to previous pads. This is a retrospective cohort study. Data from 706 patients who underwent neurosurgery between January 2018 and December 2021 were systemically reviewed. Patients undergoing long‐term neurosurgery in the neurosurgical lateral and prone positions were divided into two groups: fluidized positioners or gel pads. Propensity score matching (PSM) was performed for group balance (1:1 ratio) using the following baseline characteristics: age, gender, ASA (American Society of Anesthesiologists) classification, duration of surgery, surgical position and underlying disease. The incidence of decubitus, and length of stay (LOS) in the hospital were compared between the two groups. The results were obtained for 394 patients in the fluidized positioner group with a 3.8% incidence of pressure ulcers and 312 patients in the gel pad group with an 8% incidence of pressure ulcers, which were unbalanced in terms of gender, ASA, hypertension and diabetes data. After a PSM, patients were compared in terms of pressure ulcer incidence (3.7% vs. 7.8%, p = 0.034) and LOS (22.35 vs. 25.65 days, p < 0.001). Fluidized positioners can effectively reduce the incidence of pressure injury in lateral and prone positions of neurosurgery. The results of this study may contribute to the development of policies to prevent the development of pressure ulcers during neurosurgical procedures.

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A randomized controlled trial to compare the interface pressures of alternating pressure overlay with gel pad versus gel pad alone during prolonged surgery

Cited by 6 publications

References 40 publications

Effect of “micromovement” in preventing intraoperative acquired pressure injuries among patients undergoing surgery in supine position

Effect of “micromovement” in preventing intraoperative acquired pressure injuries among patients undergoing surgery in supine position

Using Continuous Intraoperative Pressure Mapping to Describe Patterns of Tissue Interface Pressure

The comparison of fluidized positioners and traditional gel pads for skin protection in neurosurgical patients undergoing lateral and prone positions: A retrospective analysis with propensity score matching method

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