Management of intraoperative pressure ulcer prevention in patients with ankylosing spondylitis

Abstract

Objective To explore the methods and effects of pressure ulcer prevention and management for patients receiving ankylosing spondylitis surgery. Methods Totally 51 patients who received ankylosing spondylitis surgery in our hospital from January 2015 to May 2016 were selected by purposive sampling method, excluding those who had skin damage before operation. Patients′ preoperative and postoperative skin conditions were evaluated by Waterlow pressure ulcer risk assessment scale, and corresponding prevention measures were taken based on the risk factors of pressure ulcer that they had, including targeted interview, use of TG-A arched frame, intensive wake-up tests before operation, the reduction of pressure on pressed parts with protective pad such as gel pad and foam materials, close coordination and synchronized movement between doctors and nurses in reposition during operation, and condition evaluation of pressed skin according to the staging criteria recommended by the National Pressure Ulcer Advisory Panel of America, closer attention and pressure prevention after operation. Results Among 51 patients, 35 had high risk of pressure ulcer (15-19 points) , and 16 cases had extremely high risk (≥20 points) . After pressure ulcer prevention and management, there was only one case of stage II pressure ulcer whose preoperative pressure ulcer assessment was 25, and belongs to extremely high risk, and the incidence of pressure ulcer was 1.96%. Conclusions Ankylosing spondylitis patients have high risk of pressure ulcer during the perioperative period, and targeted preventative measures can help to reduce the incidence of intraoperative pressure ulcer effectively. Key words: Spondylitis, ankylosing; Perioperative nursing; Comprehensive prevention; Pressure ulcer; Skin protection; Waterlow pressure ulcer risk assessment scale