Publication: Ameliyat öncesi ve sonrasında ameliyat sırasındakinden farklı pozisyon veilmesinin basınç yaralanmasına etkisi
Abstract
Amaç: Ameliyat öncesi ve sonrası dönemlerde, ameliyat sırasındaki pozisyondan farklı pozisyon verilmesinin ameliyat kaynaklı basınç yaralanmasına (AKBY) etkisini değerlendirmektir. Gereç ve Yöntem: Randomize kontrollü türdeki çalışma, Haziran-Aralık 2023 tarihleri arasında bir eğitim ve araştırma hastanesinin genel cerrahi klinikleri ile yoğun bakım ünitesinde majör abdominal cerrahi girişim geçiren 91 hasta ile gerçekleştirildi. Deney grubundaki (n=44) hastalara ameliyattan önceki gece ve ameliyattan sonraki ilk 36 saat dönüşümlü olarak ameliyat pozisyonundan farklı, 36. saatten sonra dönüşümlü olarak ameliyat sırasındaki ve ameliyat sırasındakinden farklı pozisyonlar verildi. Kontrol grubuna (n=47) rutin bakım dışında herhangi bir girişim uygulanmadı. Veriler Munro Basınç Yaralanması Risk Değerlendirme Ölçeği, Hasta ve Gözlemci Hareketlilik Ölçeği, Basınç Yaralanması Tanılama ve Evrelendirme Formu ve Hasta Takip Formları ile toplandı. Verilerin değerlendirilmesinde tanımlayıcı istatistiksel yöntemler, t testi, Mann-Whitney U test, Ki-Kare testleri kullanıldı (ClinicalTrials.gov numarası NCT05549830). Bulgular: Örneklemin yaş ortalaması 58,95±13,63 yıl, %59,3’ü erkek, ortalama ameliyat süresi 240,04±59,08 dk ve %78’inin ameliyat pozisyonu supine idi. Grupların ameliyat öncesi, sırası ve sonrası risk faktörlerine ilişkin özellikleri ve ameliyat öncesi basınç yaralanması riski açısından aralarında anlamlı bir fark yokken (p>0,05), ameliyat sırası ve sonrası deney grubu hastaların basınç yaralanması riski anlamlı olarak daha yüksekti (p<0,05). Çalışmada 91 hastanın 14’ünde (%15,4) toplam 16 AKBY ve 20’sinde (%22) toplam 23 solan/ beyazlaşan kızarıklık gelişti. Kontrol grubuna göre deney grubunda AKBY (sırasıyla, %25,5’e karşı %4,5) ve solan/ beyazlaşan kızarıklık (sırasıyla, %34’e karşı %9,1) oranı anlamlı olarak daha düşüktü (p<0,01). Gelişen basınç yaralanmalarının tümü Evre I olup çoğunun sakrum (%56,2), solan kızarıklıkların da koksikste (%52,2) lokalize olduğu bulundu. Sonuç: Çalışma bulguları, ameliyat öncesi ve sonrası dönemlerde ameliyat sırasındakinden farklı pozisyon verilmesinin AKBY ve solan/ beyazlaşan kızarıklık oranını azalttığını gösterdi.
Objective: To evaluate the effect of positioning in a different position from that during surgery in the pre- and post-operative periods on surgery-induced pressure injury (SIPI). Materials and Methods: The randomized controlled study was conducted with 91 patients who underwent major abdominal surgery in the general surgery clinics and intensive care unit of a training and research hospital between June and December 2023. The experimental group (n=44) was positioned in different positions from their intraoperative position during the night before the surgery and the first 36 hours following the surgery alternately, and after the 36th hour, in the intraoperative and different positions from their intraoperative position alternated. The control group (n=47) received no intervention other than routine care. Data were collected using the Munro Pressure Injury Risk Assessment Scale, Patient and Observer Mobility Scale, Pressure Injury Diagnosis and Staging Form, and Patient Follow-up Forms. The data was analyzed using descriptive statistics, t-test, Mann-Whitney U, and Chi-Square tests (ClinicalTrials.gov number NCT05549830). Results: The sample’s mean age was 58.95±13.63 years, 59.3% were male, the mean surgery duration was 240.04±59.08 min, and 78% were in a supine surgical position. While there was no significant difference between the groups in terms of pre-, intra-, and post-operative risk factors and preoperative pressure injury risk (p>0.05), the intra- and post-operative pressure injury risk was significantly higher in the experimental group (p<0.05). In the study, 14 of 91 patients (15.4%) developed a total of 16 SIPI, and 20 (22%) developed a total of 23 blanching erythema. Compared to the control group, the experimental group had significantly lower rates of SIPI (25.5% vs. 4.5%, respectively) and blanching erythema (34% vs. 9.1%, respectively) (p<0.01). All of the pressure injuries were Stage I, and most of them were localized in the sacrum (56.2%), and most of the blanching erythema was localized in the coccyx (52.2%). Conclusion: The study findings showed that positioning in a different position from that during surgery in the pre- and post-operative periods reduced the rates of SIPI and blanching erythema.
Objective: To evaluate the effect of positioning in a different position from that during surgery in the pre- and post-operative periods on surgery-induced pressure injury (SIPI). Materials and Methods: The randomized controlled study was conducted with 91 patients who underwent major abdominal surgery in the general surgery clinics and intensive care unit of a training and research hospital between June and December 2023. The experimental group (n=44) was positioned in different positions from their intraoperative position during the night before the surgery and the first 36 hours following the surgery alternately, and after the 36th hour, in the intraoperative and different positions from their intraoperative position alternated. The control group (n=47) received no intervention other than routine care. Data were collected using the Munro Pressure Injury Risk Assessment Scale, Patient and Observer Mobility Scale, Pressure Injury Diagnosis and Staging Form, and Patient Follow-up Forms. The data was analyzed using descriptive statistics, t-test, Mann-Whitney U, and Chi-Square tests (ClinicalTrials.gov number NCT05549830). Results: The sample’s mean age was 58.95±13.63 years, 59.3% were male, the mean surgery duration was 240.04±59.08 min, and 78% were in a supine surgical position. While there was no significant difference between the groups in terms of pre-, intra-, and post-operative risk factors and preoperative pressure injury risk (p>0.05), the intra- and post-operative pressure injury risk was significantly higher in the experimental group (p<0.05). In the study, 14 of 91 patients (15.4%) developed a total of 16 SIPI, and 20 (22%) developed a total of 23 blanching erythema. Compared to the control group, the experimental group had significantly lower rates of SIPI (25.5% vs. 4.5%, respectively) and blanching erythema (34% vs. 9.1%, respectively) (p<0.01). All of the pressure injuries were Stage I, and most of them were localized in the sacrum (56.2%), and most of the blanching erythema was localized in the coccyx (52.2%). Conclusion: The study findings showed that positioning in a different position from that during surgery in the pre- and post-operative periods reduced the rates of SIPI and blanching erythema.