title: Incidence and risk factors for surgically acquired pressure ulcers: a prospective cohort study investigators.
abstract: OBJECTIVE
  To assess the incidence of hospital-acquired, surgery-related pressure injury (ulcers) and identify risk factors for these injuries.
  
  
  METHODS
  We used a prospective cohort study to investigate the research question.
  
  
  METHODS
  The study was conducted at a major metropolitan hospital in Brisbane, Australia. Five hundred thirty-four adult patients booked for any surgical procedure expected to last more than 30 minutes were eligible for inclusion.
  
  
  METHODS
  Patients who provided informed consent for study participation were assessed for pressure ulcers, using the European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel Guidelines, before entering the operating room and again in the post-anesthetic care unit (PACU). Research nurses and all PACU nurses were trained in skin assessment and in pressure ulcer staging. Patients were not assessed again after their discharge from the PACU.
  
  
  RESULTS
  Seven patients (1.3%) had existing pressure injuries (ulcers) and a further 6 (1.3%) developed a surgery-related pressure ulcer. Risk factors associated with surgery-related pressure injuries were similar to non-surgically related risks and included older age, skin condition, and being admitted from a location other than one's own home. Length of surgery was not associated with pressure ulcer development in this cohort.
  
  
  CONCLUSIONS
  Perioperative nurses play an important role in identifying existing or new pressure injuries. However, many of these nurses are unfamiliar with pressure ulcer classification, so education in this area is essential. Although the incidence of surgically acquired pressure ulcers was low in this cohort, careful skin inspection before and after surgery provides an opportunity for early treatment and may prevent existing lesions progressing to higher stages.
authors.affiliation: Joan Webster, RN, BA, Nursing Director, Research, RBWH, Herston, Queensland; Griffith Health Institute, Griffith University, Kessles Rd, Nathan, QLD; and School of Nursing & Midwifery, University of Queensland, Herston, Queensland, Australia. Carolyn Lister, B App Sci (Nurs), Research Nurse, Perioperative Services, RBWH, Herston, Queensland, Australia. Jean Corry, EN (Advanced Practice), Research Nurse, Perioperative Services, RBWH, Herston, Queensland, Australia. Michelle Holland, RN, B.Bus., Risk Management Coordinator, Safety and Quality Unit, RBWH, Herston, Queensland, Australia. Kerrie Coleman, Dip ApSc, BNSc, MNclinical (Wound Management), M Nurs (Chronic Disease), Nurse Practitioner, Complex Wound Management, RBWH, Herston, Queensland, Australia. Louise Marquart, BSc, BEcon, BAppSc (Hons), B Biostat, Statistics Unit, Queensland Institute of Medical Research, Queensland, Australia.
authors.forename: Joan
authors.initials: J
authors.lastname: Webster
authors.forename: Carolyn
authors.initials: C
authors.lastname: Lister
authors.forename: Jean
authors.initials: J
authors.lastname: Corry
authors.forename: Michelle
authors.initials: M
authors.lastname: Holland
authors.forename: Kerrie
authors.initials: K
authors.lastname: Coleman
authors.forename: Louise
authors.initials: L
authors.lastname: Marquart
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009871:Operating Room Nursing / Q000379:methods / Q000592:standards; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D017592:Skin Care / Q000592:standards; D013514:Surgical Procedures, Operative / Q000009:adverse effects*