Clinical Application Of Curvilinear Supine Position On Preventing Intra-operative Pressure Ulcers In Surgical Patients

Objective: There are many measures to prevent Intra-operative pressure ulcers,while it usually occurred by some problens such as superabundant instruments,exorbitant cost,and what’s more,the prevention effect is not stable.In the current,the research of body position on the prevention of pressure ulcers is not yet mature.To explore the clinical effect of curvilinear supine position on preventing intra-operative pressure ulcers in surgical patients,we applied the curvilinear supine position,which was built up on the healthy subjects to the surgical patients and aimed to improve the construction of curvilinear supine posture on the basis of clinical practice.Methods: In this study,a randomized controlled experimental study was conducted.A total of 102 patients who met the inclusion criteria were randomly divided into test group(n = 51)and control group(n = 51)in a grade A tertiary hospital in Wuhan,Hubei Province.The control group was treated with traditional supine position,and the test group was given an improved curvilinear supine posture: lifted the head back to the angle of 10° to 12° from the horizontal plane,the leg plate was raised to an angle of 12° to 15° from the horizontal plane,and lower the feet to the horizontal plane about 14° to 18° angle.Two groups of patients were given routine pressure ulcer prevention measures.The patient’s postural comfort was measured before(baseline)and after the body position placement.After the position,we measured the angle of each section of the operating bed in the test group,and continued to monitor and record the pressure of the main compression parts of the two groups through the Xsensor X3 pressure sensing system,and the vital signs and blood oxygen saturation were also monitored.After the surgery,the satisfaction degree of surgeons,anesthesiologists and nurses to the operation positions were investigated,and the skin compression was evaluated immediately and 3 days after surgery.Results: After the surgery,1 patient was eliminated in the test group,101 patients completed the collection of all data.(1)There were no significant differences of the basic data,indexes of baseline and disease related information between two groups(Ρ>0.05).(2)After positioning,the postural comfort score of test group(3.90 ± 0.54)was significantly higher than the control group(2.67 ± 0.62,Ρ<0.01).The satisfaction degree of surgeons, anesthesiologists and nurses in operation room had no significant differences(Ρ>0.05).(3)There was no intraoperative pressure ulcer in the test group,and the rate of pressure ulcer was lower than that of the control group(17.65%,Ρ<0.01).(4)There was no significant difference in vital signs and blood oxygen saturation between the two groups,and all the indexes were in the normal range.(5)After positioning,the pressures of occipital,sacral,heel parts of the test group((42.60 ± 9.83)mm Hg,(39.33 ± 5.83)mm Hg,(47.92 ± 11.71)mm Hg)were significantly lower than that of the control group(47.64 ± 9.28)mm Hg,(44.52 ± 6.60)mm Hg,(68.86 ± 17.68)mm Hg,Ρ<0.05).(6)Five minuets after anesthesia,the pressures of occipital,sacral,heel parts in the test group((43.37 ± 9.52)mm Hg,(40.20 ± 5.91)mm Hg),(48.32 ± 11.02)mm Hg)were significantly lower than that of the control group((48.01 ±8.93)mm Hg,(44.92 ±6.01)mm Hg,(72.14 ± 20.55)mm Hg,Ρ<0.05).(7)With prolonged operation time,the pressure on the scapular part and heel of the test group was continued to decrease than that of the control group(Ρ<0.05).The test group of leg pressure was higher than that of control group(Ρ<0.05),and the pressure of the occipital and the scapular was lower than that of the control group without statistical significance(Ρ>0.05).Conclusions: The use of curve supine position can reduce the incidence of pressure ulcers through the improvement of pressure protection in short-term and long-term,it can improve the patient’s postural comfort,and will not have a negative impact on the patient’s vital signs and blood oxygen saturation.This study provides a foundation and reference for the nursing staff in the future,and at the same time,it also provides a new perspective for nursing managers in the prevention of pressure sores.