title: Risk factors associated with intraoperatively acquired pressure ulcers in the park-bench position: a retrospective study.
abstract: Patients undergoing surgery in the park-bench position are at high risk of developing intraoperatively acquired pressure ulcers (IAPUs). The purpose was to examine retrospectively risk factors associated with IAPUs in the park-bench position. This study was conducted at a general hospital during the period of September 2010 to September 2012. Twenty-one potential risk factors were evaluated using data obtained from the hospital database. IAPUs developed in 30 of 277 patients (11%). Perspiration was statistically found to be independently associated with IAPUs [OR 3·09, 95% confidence interval (Cl) 1.07-8·58, P = 0·037]. A length of surgery of more than 6 hours was identified to be likely associated with IAPUs (OR 2·64, 95% Cl 0·84-9·08, P = 0·095) compared with less than 6 hours. Furthermore, there was an interaction between the length of surgery and the core temperature; that is, when the length of surgery was more than 6 hours, a core temperature of more than 38·1°C at the end of surgery had a higher odds ratio (8·45, 95% Cl 3·04-27·46, P < 0·001) than that at a lower core temperature (3·20, 95% Cl 1·23-8·78, P = 0·017). These results suggest that perspiration and core temperature are preventable causative factors of pressure ulcers, even under conditions of prolonged surgery in the park-bench position.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Department of Nursing, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
authors.forename: Mine
authors.initials: M
authors.lastname: Yoshimura
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Iizaka
authors.affiliation: Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Michihiro
authors.initials: M
authors.lastname: Kohno
authors.affiliation: Department of Anesthesiology, Cancer Institute Hospital, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nagata
authors.affiliation: Department of Anesthesiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamasaki
authors.affiliation: Department of Anesthesiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Mae
authors.affiliation: Department of Anesthesiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Haruyama
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D006801:Humans; D016017:Odds Ratio; D011187:Posture; D003668:Pressure Ulcer; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Core temperature; Perioperative nursing; Perspiration; Pressure ulcer prevention; Surgery