Prevention problems and effect analysis of pressure ulcers in 134 patients with aortic dissection surgery

Abstract

Objective To explore the skin management methods for preventing pressure ulcers in the patients with aortic dissection surgery. Methods Totals of 134 cases of patients with aortic dissection surgery were implemented the standardized and personalized skin management methods for preventing pressure ulcers. The Waterlow patients pressure sore risk assessment was applied in assessing the skin condition of preoperative and postoperative patients. The prevention methods according to the risk factors of pressure ulcer, including the targeted health education, improve the compliance of prevention methods; using the silicone gel pad, water gel or foam dressing to decompress the pressurized parts during the operation, when the operation time was over 2 hours, lifted patients′ head and foot every half hour and changing stress points; during the postoperative time turning-over and using the air bed. Results The scores of pressure ulcer were (10.43±2.79) and (13.93±3.28) before and after surgery. All the 134 patients did not have pressure ulcer before surgery. One day after the operation, 3 patients had phase Ⅰ pressure ulcer, with an incidence of 2.24%. Within the 3 cases of pressure ulcer patients, 1 patient was emaciation, 2 patients had long operation time (11.5 and 14.5 hours, respectively), whose pressure ulcer scores were 22 to 23 belong to the risk level. Conclusions Patients with aortic dissection during perioperative period have a high risk of pressure sores. The implementation of specific preventive measures can effectively reduce the incidence of pressure sores. Long procedure and partial compression caused by fixed position are the greatest difficulties in preventing the pressure sores, and they are also the problems needed to be solved in the future. Key words: Health education; Skin management; Pressure ulcer; Aortic dissection; Waterlow scale