Intraoperative use of low-profile alternating pressure mattress for prevention of hospital acquired pressure injury

Abstract

BackgroundFacility acquired pressure injury is a problem in all care settings. Further work is necessary to better understand and intervene in specific scenarios. The operating room has not been well studied with respect to pressure injury prevention. Our purpose was to study the efficacy of a low profile alternating pressure (AP) overlay to prevent operating room associated pressure injuries. MethodsThis was a prospective case control study conducted in the operating room and critical care unit of an urban quaternary care hospital in the United States. Neurosurgery patients undergoing surgery for 2 hours or longer in the supine position were included in the study and assigned to receive the AP overlay in the operating room and in the Neurosurgical Intensive Care Unit (NICU) or standard treatment (control). The patients were then followed daily until discharge. Standard protocols for pressure injury prevention were maintained. Demographic data, details of the operation, pressure injury risk factors and presence of hospital acquired pressure injuries (HAPI) were recorded. The primary outcome of interest was the incidence of HAPI in the AP group compared to the control group. Results212 patients were enrolled into the study. 104 received the AP system whereas 108 did not. The average length of stay in the NICU for the AP group was 2.2+/− 1.6 days and 2.4 +/−0.5 days for the control group (p =0.078). The average OR case length was 4.5+/− 0.8 hours for the AP group and 3.9+/−1.2 hours for the controls (p = 0.014). In the AP group, 1 patient out of 104 (0.96%) developed a pressure injury whereas 7 patients out of 108 (6.48%) developed a pressure injury in the control group (p =0.014). There were no adverse events or unintended consequences resulting from use of the AP overlays in the operating room or NICU ConclusionsLow Profile Alternating Pressure mats are a safe and effective way to prevent hospital acquired pressure injuries and should be considered in patients undergoing complex procedures with increased operative time.