Ameliyat Kaynaklı Basınç Yaralanmalarını Önlemede Etkili Kanıt Temelli Girişimler

Year 2021, Volume: 8 Issue: 1, 85 - 92, 31.03.2021

Didem Kandemir Serpil Yüksel

https://doi.org/10.31125/hunhemsire.907916

Cited By: 3

Abstract

Cerrahi girişim geçiren hastalar, basınç yaralanmaları açısından yüksek risk altındadır. Özellikle uzun süren cerrahi girişimler sırasında basıncın etkisiyle dokuda oluşan değişim, ameliyat sonrası 3-7. günlerde ciddi basınç yaralanmaları ile sonuçlanabilmektedir. Bu derlemede, ameliyat kaynaklı basınç yaralanmalarını önlemede etkili kanıt temelli girişimleri literatür ışığında tartışmak amaçlandı. Derlemede, elektronik veri tabanları taranarak elde edilen, 2006-2020 yılları arasında yayınlanmış, tam metnine ulaşılabilen, ameliyat kaynaklı basınç yaralanmaları ile ilgili çalışma ve rehberler incelendi. Ameliyat sırasında basınç yaralanması oluşma sıklığı %1.3-51 arasında değişmekte olup, tüm hastane kaynaklı basınç yaralanmalarının %45’ini oluşturmaktadır. Ameliyat kaynaklı basınç yaralanmalarını önlemede etkili kanıt temelli girişimler; risk değerlendirmesi, pozisyon verme, koruyucu örtü ve destek yüzey kullanımı başlıkları altında ele alınmıştır. Bu yaralanmaları önlemek amacıyla öncelikle uzun ameliyat süresi, hipotermi ve hipotansif ataklar gibi basınç yaralanması riskini artıran faktörler belirlenmelidir. Ameliyat masasında, basıncı dağıtan destek yüzeyler kullanılmalıdır. Ameliyat sırasında hastaya basınç yaralanması riskini azaltacak şekilde pozisyon verilmeli ve topuklar elevasyona alınmalıdır. Gerekirse, topuk süspansiyon cihazları kullanılmalıdır. Ameliyat sonrası dönemde mutlaka ameliyat sırasında verilen pozisyondan farklı bir pozisyon verilmelidir. Sonuç olarak, ameliyat kaynaklı basınç yaralanmalarını önlemede, bireysel ve cerrahi girişim ilişkili risk faktörlerinin dikkatle değerlendirilmesi ve önleme girişimlerinin bu faktörler ve kanıt temelli girişimler dikkate alınarak planlanması önemlidir.

Keywords

Ameliyathane, ameliyat sırası, basınç yaralanması, kanıta dayalı uygulamalar, önleme

Effective Evidence-Based Practices in Preventing Intraoperatively Acquired Pressure Ulcers

Abstract

Patients undergoing surgery are at high risk for pressure injuries. Especially during long-term surgical interventions, the change in tissue caused by pressure may result in serious pressure injuries in the 3-7. days after surgery. In this review, it was aimed to discuss evidence-based interventions that are effective in preventing intraoperatively acquired pressure in the light of the literature. In the review, studies and guides on intraoperatively acquired pressure ulcers, which were obtained by scanning electronic databases, published between 2006-2020, and whose full text was available, were examined. The incidence of intraoperatively acquired pressure ulcers varies between 1.3-51%, and this ratio constitutes 45% of all hospital-acquired pressure ulcers. Effective evidence-based interventions in preventing intraoperatively acquired pressure ulcers were discussed under the titles of risk assessment, positioning, use of prophylactic dressing, and support surface. In order to prevent these injuries, factors that increase the risk of pressure injuries such as long operation time, hypothermia, and hypotensive attacks should be determined. On the operating table, pressure redistributing mattresses should be used. During the operation, the patient should be positioned in a way that reduces the risk of pressure injury, and the heels should be elevated. If necessary, heel suspension devices should be used. In the postoperative period, a different position should be given from the position given during the operation. In conclusion, in preventing surgical pressure injuries, it is important to carefully evaluate individual and surgical intervention-related risk factors and plan prevention interventions by considering these factors and evidence-based interventions.

Keywords

Evidence-based practice, intraoperative, operating room, pressure injury, prevention

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