Research On The Methods For Protecting The Skin The Of Patients’ Head And Face With Posterior Spinal Operation

Pressure sore also called pressure ulcer (PU), is one of themost common clinical complications[1]. European Pressure UlcerAdvisory Panel suggested[2]that up to18%of hospitalizedpatients would occur pressure ulcer. The incidence of domesticpressure sores in hospitalized patients is2.5%～15%, inwhich for the prone position with the incidence of2.5%～8.8%,and even up to11.6%. The occurrence of the pressure ulcers inthe head and face can not only bring pains to the patients, butalso reduce the quality of life.The pressure ulcer which wasprolonged unhealed can also cause serious infection, systemicfailure and life-threatening[3]. The prone position is the mostcommon position of posterior spinal operation[4]. Because ofthe large wound and the long time of the spinal operation, itwill do harm to the patients during the long-playing operationwith improper operation positions or protective measures[5].Using the head facial protection is the main measure forpreventing surgical facial pressure ulcers. However, theexisting frame specifications are limited. It can not accordingto individual face make flexible adjustment to protect thepatient’s head of facial skin. So that, We according to thetraditional facial protection has to be improved on the basis of in-depth study, and evidence-based experimental research.By comparison, we concluded that application of the modifiedhead frame in the prone position spinal posterior surgery canreduce the incidence of pressure ulcers in the head and faceand promote the development of clinical protection frame. Atthe same time, it also provides more reference value forclinical prevention of pressure ulcers.Objective: Through the comparison of the incidence of facialpressure ulcers between the two groups of patients, toinvestigate the application of modified frame in the posteriorspinal operation and its effect on the incidence of thepatients’craniofacial complications.Methods: Utilizing the randomized controlled grouping method,we have chosen160patients from patients who underwentposterior spinal operation at the China-Japan Union hospitalfrom2012August to2013December. According to the inclusionand exclusion criteria, the160surgical patients selected wererandomly divided into experimental group and control group. The80cases of the experimental group, after performing successfulnarcotic and protective measures for the head, face, eyelid,used the improved prone position frame; the80cases of thecontrol group, after performing successful narcotic and protective measures for the head, face, eyelid, used theexisting ‘horseshoe’ head in the operation room. And beforethe operation, we used the ‘Operation pressure sore riskassessment scale (Braden)’to assess the facial skin conditionof operation patients. After the operation, we used ‘Table ofassessment of facial skin damage to assess the facial skincondition of operation patients, and made the patientsatisfaction survey.Results: The ‘assessment form operation pressure ulcer risk(Braden)’ were used in patients of the experimental group toassess their skin conditions before the operation. Theexperimental group has17people prone to pressure ulcers. Thecontrol group has19people prone to pressure ulcers. Accordingto the comparison, it showed that the pressure ulcer risk forthe patients of the experimental group was no difference withthe control group. There was no statistically significantdifference (P>0.05). The ‘facial skin damage assessmenttable’ was used to assess the patients’ skin conditions afterthe operation. There are12cases of patients with head facialskin damage，3cases of patients with complications in theexperimental group patients. In the control group patients,there are27cases of patients with head facial skin damage， 13cases of patients with complications. The comparison of thefacial pressure ulcer incidence in the two groups showed thatexperimental group patients who used modified head facialprotection frame was significantly lower than that of thecontrol group patients who used “horseshoe” head facialprotection frame. The difference was statistically significant(P﹤0.05). Satisfaction survey were made on the patients of twogroups, according to the selection criteria, the experimentalgroup78people, control group66people. We used X2test forstatistical analysis and showed that the satisfaction of theexperimental group patients was significantly higher than thecontrol group patients. There was statistically significantdifference (P <0.05).Conclusion: Through the comparative study of pressure sores intwo groups of patients with operation, the results showed thatfor the posterior spinal operation patients who used theimproved prone position head frame, the decrease of thepressure ulcer incidence is more obvious than that of thepatients who used the existing ‘horse shoe’ head frame in theoperation room. Improved head frame can be adjusted flexiblyaccording to the patient’s facial features, and it can beaccorded with human body head facial physiological structure, increase patient comfort in the process of operation, shortenthe hospitalization days of patients, reduced the economicburden of patients, and improve patients’ satisfaction. But itdid not fundamentally solve the problem of patients with headface pressure ulcers.Improved head frame is a better headprotection method.