Retrospective review of predisposing factors for intraoperative pressure ulcer development

J Clin Anesth. 2014 Aug;26(5):368-74. doi: 10.1016/j.jclinane.2014.01.012. Epub 2014 Aug 10.

Abstract

Study objective: To evaluate the comorbidities and surgical factors involved in the genesis of intraoperative pressure ulcers.

Design: Retrospective chart review.

Setting: Anesthesiology department of a university medical center.

Measurements: The charts of 222 patients with varying illness, who underwent an operation of at least two hours' duration, were analyzed retrospectively. Data on surgery type, case length, comorbidities, intraoperative surgical position, and area of ulceration were recorded.

Main results: Risk factors for intraoperative pressure ulcer development include surgical times of 4 hours or longer; comorbidities affecting tissue perfusion (namely, diabetes, hypertension, and nonspecific cardiac issues); supine placement during surgery; and abdominal, noncardiac thoracic, and orthopedic operations. Regions of the body most at risk for ulceration include the coccygeal/sacral region, the buttocks, genitalia, and heels.

Conclusions: Pressure ulcers are a costly, debilitating, and avoidable complication of surgery.

Keywords: Anesthesia; Intraoperative; Pressure ulcers.

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intraoperative Complications / epidemiology*
  • Intraoperative Complications / etiology
  • Intraoperative Complications / pathology
  • Male
  • Middle Aged
  • Operative Time*
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / etiology
  • Pressure Ulcer / pathology
  • Retrospective Studies
  • Risk Factors
  • Young Adult