Support surfaces in the prevention of pressure ulcers in surgical patients: An integrative review

Oliveira, Karoline Faria de; Nascimento, Kleiton Gonçalves do; Nicolussi, Adriana Cristina; Chavaglia, Suzel Regina Ribeiro; Araújo, Cleudmar; Barbosa, María Helena

doi:10.1111/ijn.12553

Cited by 31 publications

(40 citation statements)

References 31 publications

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“…In order for interventions to be effective in preventing skin injuries, they must be related to pressure relief while and immediately after the patient remains on the operating table, and examples of effective devices for such prevention are dry viscoelastic polymer mattress toppers and gel pads (5) .…”

Section: Introductionmentioning

confidence: 99%

Risk for surgical positioning injuries: scale validation in a rehabilitation hospital

Nascimento¹,

Rodrigues

2020

Rev. Latino-Am. Enfermagem

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Objective: to validate the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning in the stratification of risk for injury development in perioperative patients at a rehabilitation hospital. Method: analytical, longitudinal and quantitative study. An instrument and the scale were used in the three perioperative phases in 106 patients. The data were analyzed using descriptive and inferential statistics. Results: most patients showed high risk for perioperative injuries, both in the scale score with estimated time and in the real-time score, with a mean of 19.97 (±3.02) and 19.96 (±3.12), respectively. Most participants did not show skin lesions (87.8%) or pain (92.5%). Inferential analysis enabled us to assert that the scale scores are associated with the appearance of injuries resulting from positioning, therefore, it can adequately predict that low-risk patients are unlikely to have injuries and those at high risk are more likely to develop injuries. Conclusion: the scale validation is shown by the association of scores with the appearance of injuries, therefore, it is a valid and useful tool, and it can guide the clinical practice of perioperative nurses in rehabilitation hospitals in order to reduce risk for injuries due to surgical positioning.

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Section: Introductionmentioning

confidence: 99%

Risk for surgical positioning injuries: scale validation in a rehabilitation hospital

Nascimento¹,

Rodrigues

2020

Rev. Latino-Am. Enfermagem

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“…Outro fator de risco no intraoperatório é o tipo de anestesia, que influencia no grau de depressão do sistema nervoso, em que ocorre vasodilatação periférica, resultando em hipotensão e diminuição do retorno venoso, depressão dos receptores da dor, fazendo com que os mecanismos de defesa do paciente não ofereçam mais proteção contra pressão, deixando-os suscetíveis a lesões perioperatórias decorrentes do posicionamento [17][18][19][20] .…”

Section: Discussionunclassified

“…Têm como objetivo evitar atritos, prevenindo LP, compressão ou estiramentos neuromusculares, contato com o metal da mesa, que pode ocasionar queimaduras (devido ao uso do bisturi elétrico) e outros danos 21,22 . Todavia, as superfícies de suporte são pouco utilizadas nos pacientes cirúrgicos, uma vez que as questões políticas, econômicas e sociais enfrentadas pela saúde no país não permitem que muitos serviços públicos disponham desses tipos de recursos tecnológicos, interferindo diretamente na prevenção de lesões [9][10][11][12][13][14][15][16][17][18][19][20] .…”

Section: Discussionunclassified

“…No estado de Minas Gerais, pesquisas realizadas identificaram taxas de incidência em que 21,7 e 74% dos pacientes apresentaram LP ao término do procedimento cirúrgico 7,9 . Conforme destacado, a incidência de lesões perioperatórias decorrentes do posicionamento permanece alta por causa da ausência de medidas preventivas para evitar tais lesões, sendo a não adesão ou verificação de normas e/ou protocolos de diretrizes clínicas o principal fator contribuinte [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] .…”

Section: Discussionunclassified

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Fatores associados a lesões de pele decorrentes do período intraoperatório

et al. 2019

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Objetivo: Avaliar a ocorrência de lesões de pele no período intraoperatório decorrentes de procedimentos cirúrgicos realizados em um hospital universitário de grande porte. Método: Estudo transversal, descritivo, com abordagem quantitativa, realizado em um hospital universitário do Recife, Pernambuco, Brasil. A amostra foi constituída de 154 pacientes submetidos a cirurgias eletivas entre os meses de janeiro e abril de 2018, avaliados nos períodos pré e pós-operatório, por meio da aplicação da Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico (ELPO), no intraoperatório. A coleta de dados ocorreu na visita pré-operatória e no primeiro dia de pós-operatório. Resultados: Dos 154 pacientes avaliados, sete apresentaram 11 lesões de pele, como lesões por pressão estágio I, estágio II e abrasão, predominantemente no glúteo e no tórax. As variáveis tempo do procedimento cirúrgico, tipo de anestesia e comorbidades foram os principais fatores de associados à ocorrência das lesões. Conclusão: Entre os pacientes que apresentaram lesões de pele devido ao posicionamento cirúrgico, a maioria foi classificada pela ELPO como alto risco, o que leva a crer que se trata de uma escala adequada para avaliação de risco de lesões de pele em pacientes cirúrgicos.

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“…Other well-known position-related injuries related to surgery are pressure ulcers, which occur due to unrelieved pressure, usually over bony prominences. The pressure can cause ischaemia, cell death and tissue necrosis (Shaw, Chang, Lee, Kung, & Tung, 2014), and there is evidence of a high incidence of pressure ulcers related to surgical procedures (de Oliveira et al, 2017). The incidence varies greatly, and a previous systematic review found that the incidence ranged from 0.3%-57.4% worldwide (Chen, Chen, & Wu, 2012).…”

Section: Pressure Ulcersmentioning

confidence: 99%

Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

Johansson

Vogelsang

2019

Journal of Clinical Nursing

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Aims and objectives To describe patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy in patients with bladder cancer. Background Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well‐known after prolonged surgery, especially in robot‐assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient‐related and operative risk factors. Methods A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study‐specific questionnaire 7–10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. Results Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7–10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. Conclusion A large proportion of the patients report postoperative extremity symptoms after robot‐assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow‐ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. Relevance to clinical practice This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow‐ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence‐based positioning guidelines in the operating theatre for optimal positioning.

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Support surfaces in the prevention of pressure ulcers in surgical patients: An integrative review

Abstract: There are gaps in knowledge regarding the most efficient support surfaces and the specifications of the products used to prevent pressure ulcers due to surgical positioning.

Cited by 31 publications

References 31 publications

Risk for surgical positioning injuries: scale validation in a rehabilitation hospital

Risk for surgical positioning injuries: scale validation in a rehabilitation hospital

Fatores associados a lesões de pele decorrentes do período intraoperatório

Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

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