4点式架台を使用した腹臥位手術における皮膚・皮下損傷予防に対する5年間の取り組み

抄録

  Background : A four-point spinal frame helps to reduce blood loss during prone position surgery. Although effective in decreasing intra-abdominal and venous pressure, the resulting smaller areas of body surface contact have an increased risk of postoperative pressure ulcer formation. We report the results of our efforts to minimize the risk of ulcer formation in the last 5 years.

  Methods : Our basic idea was to pad the table with a foam sheet. In addition, the sheet was covered with sheepskin or paper toweling. We performed a retrospective analysis of medical records with special focus on whether a patient developed pressure injury from contact with the operating table. Patients were divided into three groups according to the body support method. The incidence of pressure injury was determined in each group.

  Results : When the total surgical time was less than 8 hours, our preventive method was effective in reducing intraoperative pressure injury from 27% to 18%. However, the incidence was 78% when the surgical time exceeded 8 hours, even with the newer preventive technique.

  Conclusion : This study showed that our approach to minimizing the risk of postoperative pressure injury using a combination of padding and covering was effective. However, surgical time was more strongly associated with the incidence of injury. Planning for a total surgical time of less than 8 hours should be considered.