Ameliyathane Kaynaklı Basınç Yaraları Önlenebilir mi?

Öz

Ameliyathane kaynaklı basınç yarası, ameliyattan sonra 48-72 saat içinde gelişen ve çok yaygın görülen bir sorundur. Sağlık bakım hizmetlerinin kalite göstergelerinden olan basınç yaraları, sağlık hizmetlerindeki gelişme ve yeniliklere karşın tüm Dünya’da sık karşılaşılan önemli sağlık sorunlarından biridir. Basınç yaraları, risk faktörlerinin belirlenmesi, erken teşhis edilmesi ve iyi bir hemşirelik bakımı ile %90 oranında önlenebilir. Hemşireler ve ameliyathanede çalışan tüm sağlık profesyonelleri ameliyathane kaynaklı basınç yarası için risk oluşturan faktörleri bilmeli, önlemek için gerekli bütün girişimleri uygulamalıdır. Bu derlemede de cerrahi girişim geçiren hastalarda ameliyathane kaynaklı basınç yarası oluşumuna sebep olan risk faktörlerinin ve önlemek için yapılan uygulamaların son çalışmalar ışığında incelenmesi amaçlanmıştır.

Anahtar Kelimeler

• Basınç Yarası
• Cerrahi Girişim
• Ameliyathane Hemşireliği

Can Pressure Ulcers From The Operating Room Be Prevented?

Öz

Operating room-induced pressure ulcer is a common problem that develops within the first 48-72 hours after surgery. Pressure ulcers, which are considered one of the quality indicators in health care, are one of the most common and important health problems in the world, despite Development and innovation in health care. Pressure ulcer can be prevented by 90% by identifying risk factors, early detection, and good nursing care. All health professionals working in the operating room, especially nurses, should know the risk factors for the pressure ulcer caused by the operating room and implement the necessary initiatives to prevent it. In this review, it was aimed to examine the risk factors and prevention practices involved in the development of pressure ulcers in patients undergoing surgical intervention in the light of recent studies.

Anahtar Kelimeler

• Pressure Ulcer
• Surgical Intervention
• Operating Room Nursing

Kaynakça

1. 1. Edsberg LE, Black JM, Goldberg M, McNichol L, Moore L, Sieggreen M. Revised national pressure ulcer advisory panel pressure ınjury staging system: Revised pressure ınjury staging system. J Wound Ostomy Continence Nurs. 2016 Nov/Dec;43(6):585-597. doi: 10.1097/WON.0000000000000281. PMID: 27749790; PMCID: PMC5098472.
2. 2. Ünver S, Yıldırım M, Akyolcu N, Kanan N. Concept analysis of pressure sores: Florence Nightingale Journal of Nursing. 2015;22(3):168-171.
3. 3. Benevıdes JL, Coutınho JVF, Tomé MABG, Gubert FA, Sılva TBC, Olıveıra SKPO. Nursing strategies for the prevention of pressure ulcers in ıntensive therapy: ıntegrative review. Journal of nursing ufpe 2017;11(5):1943-1952. doi: 10.5205/1981-8963-v11i5a23344p1943-1952-2017
4. 4. Agrawal K, Chauhan N. Pressure ulcers: Back to the basics. Indian J Plast Surg 2012 May;45(2):24454. doi: 10.4103/0970-0358.101287. PMID: 23162223; PMCID: PMC3495374.
5. 5. Mervis JS, Phillips TJ. Pressure ulcers: Pathophysiology, epidemiology, risk factors and presentation. J Am Acad Dermatol 2019 Oct;81(4):881-890. doi: 10.1016/j.jaad.2018.12.069. Epub 2019 Jan 18. PMID: 30664905.
6. 6. Becker D, Tozo TC, Batista SS, Mattos AL, Silva MCB, Rigon S, et al. Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. Intensive and Critical Care Nursing 2017;42(10):55-61.
7. 7. El-Marsi J, Zein-El-Dine S, Zein B, Doumit R, Kurdahi Badr L. Predictors of Pressure Injuries in a Critical Care Unit in Lebanon: Prevalence, Characteristics, and Associated Factors. J Wound Ostomy Continence Nurs. 2018 Mar/Apr;45(2):131-136. doi: 10.1097/WON.0000000000000415. PMID: 29521923.
8. 8. Ülker Efteli E, Güneş Ü. Basınç yarası gelişiminde perfüzyon değerlerinin etkisi: Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi 2014;17(3):0-.

9. 9. Kaşıkçı M, Aksoy M, Ay E. Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: A cross-sectional study. J Tissue Viability 2018 Aug;27(3):135-140. doi: 10.1016/j.jtv.2018.05.001. Epub 2018 May 16. PMID: 29776817.
10. 10. Katran HB. The research on the incidence of pressure sores in a surgical intensive care unit and the risk factors affecting the development of pressure sores: Journal of Academic Research In Nursing 2015;1(1):8-14. doi: 10.5222/jaren.2015.008
11. 11. Tanrıkulu F, Dikmen Y, Tanrıkulu F. Yoğun bakım hastalarında basınç yaraları, risk faktörleri ve önlemler: Journal of Human Rhythm 2017;3(4):177-182.
12. 12. Association of Perioperative Registered Nurses. Position statement on perioperative pressure ulcer prevention in the care of the surgical patient. AORN Journal 2016;104(5):437-438.21. http://www.aorn.org/aorn-org/guidelines/
13. 13. Gefen A. How much time does it take to get a pressure ulcer? Integrated evidence from human, animal, and in vitro studies. Ostomy Wound Manage 2008 Oct;54(10):26-8,30-5. PMID: 18927481.
14. 14. Menezes S, Rodrigues R, Tranquada R, Müller S, Gama K, Manso T. Lesões decorrentes do posicionamento para cirurgia: incidência e fatores de risco [Injuries resulting from positioning for surgery: incidence and risk factors]. Acta Med Port 2013 Jan-Feb;26(1):12-6. Portuguese. Epub 2013 Apr 24. PMID: 23697352.
15. 15. Bulfone G, Marzoli I, Quattrin R, Fabbro C, Palese A. A longitudinal study of the incidence of pressure sores and the associated risks and strategies adopted in Italian operating theatres. JPerioperPract 2012;22(2):50-12. Availablefrom: https:// www. ncbi. nlm. nih. gov/ pubmed/ 22724304
16. 16. Saraiva IL, Paula MFC, Carvalho R. Pressure ulcer in the transoperative period: occurrence and associated factors. Rev SOBECC 2014;19 (4):207-13.
17. 17. Celik B, Karayurt Ö, Ogce F. The effect of selected risk factors on perioperative pressure ınjury development. AORN J 2019 Jul;110(1):29-38. doi: 10.1002/aorn.12725. PMID: 31246295.
18. 18. Ter N, Yavuz van Gıersbergen M. Basınç yaralarının önlenmesi, Ameliyathane Hemşireliği Kitabı: Yavuz van Gıersbergen M., Kaymakçı Ş., İzmir; Meta Basım ve Matbaacılık Hizmetleri 2015;483 – 488.
19. 19. Spruce L. Back to basics: Preventing perioperative pressure ınjuries. AORN J 2017 Jan;105(1):92-99. doi: 10.1016/j.aorn.2016.10.018. PMID: 28034406.
20. 20. Huang HY, Chen HL, Xu XJ. Pressure-redistribution surfaces for prevention of surgery-related pressure ulcers: A meta-analysis. Ostomy Wound Manage 2013 Apr;59(4):36-8,42, 44, 46, 48. PMID: 23562873.
21. 21. de Oliveira KF, Nascimento KG, Nicolussi AC, Chavaglia SRR, de Araújo CA, Barbosa MH. Support surfaces in the prevention of pressure ulcers in surgical patients: An integrative review. Int J Nurs Pract 2017 Aug;23(4). doi: 10.1111/ijn.12553. Epub 2017 Jun 23. PMID: 28643855.
22. 22. Lumbley JL, Ali SA, Tchokouani LS. Retrospective review of predisposing factors for intraoperative pressure ulcer development. J Clin Anesth 2014 Aug;26(5):368-74. doi: 10.1016/j.jclinane.2014.01.012. Epub 2014 Aug 10. PMID: 25113424.
23. 23. Chen HL, Chen XY, Wu J. The incidence of pressure ulcers in surgical patients of the last 5 years: A systematic review. Wounds 2012 Sep;24(9):234-41. PMID: 25874704.
24. 24. Scarlatti KC, Marlene- Michel JL, Gamba MA, Rivero de Gutiérrez MG. Pressure soress in surgery patients incidence and associated factors. Revista da Escola de Enfermagem da USP 2011; 45(6):1369-1375.
25. 25. Edsberg LE, Langemo D, Baharestani MM, Posthauer ME, Goldberg M. Unavoidable pressure ınjury state of the science and consensus outcomes. J Wound Ostomy Continence Nurs 2014;41(4):313-334.
26. 26. Fred C, Sharonford C, Doreenwagner C, Vanbrackle CL. Intraoperatively acquired pressure soress andperioperative normothermia: A look at relationships. AORN Journal 2012;96(3): 251-260.
27. 27. Yusuf S, Okuwa M, Shigeta Y, Dai M, Luchi T, Rahman S, et al. Microclimate and development of pressure soress and superficial skin changes. International Wound Journal 2013;40-46.
28. 28. Yoshimura M, Iizaka S, Kohno M, Nagata O, Yamasaki T, Mae T, Haruyama N, Sanada H. Risk factors associated with intraoperatively acquired pressure ulcers in thepark-bench position: A retrospective study. Int Wound J 2016;13:1206–1213.
29. 29. Angmorterh SK, England A, Webb J, Szczepura K, Stephens M, Anaman-Torgbor J, et al. An investigation of pressure ulcer risk, comfort, and pain in medical imaging. Journal of Medical Imaging and Radiatiom Science 2019;50(1), 43-52. doi: 10.1016/j.jmir.2018.07.003
30. 30. Hayes RM, Spear ME, Lee SI, Krauser Lupear BE, Benoit RA, Valerio R, Dmochowski RR. Relationship between time in the operating room and incident pressure ulcers: A matched case-control study. Am J Med Qual 2015 Nov-Dec;30(6):591-7. doi: 10.1177/1062860614545125. Epub 2014 Jul 30. PMID: 25077711.
31. 31. Wright KM, Van Netten Y, Dorrington CA, Hoffman GR. Pressure injury can occur in patients undergoing prolonged head and neck surgery. J Oral Maxillofac Surg 2014 Oct;72(10):2060-5. doi: 10.1016/j.joms.2014.04.018. Epub 2014 Apr 24. PMID: 25053571.
32. 32. Khong BPC, Goh BC, Phang LY, David T. Operating room nurses’ self reported knowledge and attitu de on perioperative pressure injury. International Wound Journal 2020;17(2), 455-465. doi: 10.1111/iwj.13295.
33. 33. Monahan FD, Sands JK, Neighbors M, Maker JF, Green CJ. (2006). Phipps Medical Surgical Nursing.(8. Baskı)
34. 34. Çınar F, Kula Şahin S, Eti Aslan F. Evaluation of studies in turkey on the prevention of pressure sores ın the ıntensive care unit: A systematic review. Health Science Journal 2018;7(1):42-50.
35. 35. Soyer Ö, Özbayır T. 3S Ameliyathane Basınç Yarası Risk Tanılama Ölçeği’nin Türkçe’ye Uyarlanması. Uluslararası Hakemli Hemşirelik Araştırmaları Dergisi Mayıs / Haziran / Temmuz / Ağustos İlkbahar Yaz Dönemi 2018;Sayı:13 Doi: 10.17371/UHD.2018.2.9
36. 36. Registered Nurses’ Association of Ontario- RNAO. Assesment and Management of Pressure İnjuries for the Interprefossional Team Third Edition. Toronto: Registered Nurses’ Association of Ontario Publishing 2016. http://www.rnao.ca/bpg
37. 37. Avşar P, Karadağ A. Waterlow Basınç Ülseri Risk Değerlendirme Ölçeği’nin Türkçeye Uyarlanması, Geçerlik-Güvenirlik Çalışması. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2016;3(3):1-15.
38. 38. Association of PeriOperatif Registered Nurses. Guideline for Positioning the Patient. Wahl RL, ed. Perioperative Standards and Recommended Practices. Denver: CO 2015;p.563-81.
39. 39. Haesler E, editör. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide. Indıvıduals ın the operatıng room. Cambridge Media: Osborne Park, Australia 2014;57-59.
40. 40. Karacabay K. Pozisyon verme. Yavuz van Giersbergen M, Kaymakçı Ş. Ameliyathane Hemşireliği. İzmir: Meta Basım ve Matbaacılık Hizmetleri 2015;p.459-76.
41. 41. Engels D, Austin M, McNichol L, Fencl J, Gupta S, Kazi H. Pressure ulcers: factors contributing to their development in the OR. AORN J 2016;103(3):271-281
42. 42. Song JB, Vemana G, Mobley JM, Bhayani SB. The second “timeout”: a surgical safety checklist for lengthy robotic surgeries. Patient Saf Surg 2013;7(1):19.
43. 43. Gül Ş. Cerrahi girişim uygulanan hastalarda basınç ülseri gelişiminin önlenmesi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi 2014;54–61.
44. 44. Çelik S, editör. Taşdemir N, Yard. Editör. Güncel Yöntemlerle Cerrahi Hastalıklarda Bakım. Çukurova Nobel Tıp Kitaevi 2018; (s.43-74).
45. 45. Eyi S, Kanan N, Akyolcu N. Ameliyat sırası dönemde kaliteli hemşirelik bakımına ulaşmada hemşirenin rolü. F.N. Hem. Derg 2017;25(2): 126-138.ISSN 2147-4923 Derleme Makalesi
46. 46. Guideline for positioning the patient. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2018:673‐744. https://www.guidelinecentral.com/summaries/guideline-for-positioning-the-patient/ Erişim Tarihi: 17.02.2021
47. 47. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Basınç Ülserlerinin/Yaralarının Önlenmesi ve Tedavisi: Hızlı Başvuru Kılavuzu 2019. (Türkçe versiyon).Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA: 2019.
48. 48. Association of PeriOperative Registered Nurses (AORN). (2019). Positioning the Patient. Guidelines For Perioperative Practice 2019 Edition. Editor: Wood A, Denver CO. Canada. 637-713.