Trauma Nursing
Comparison of efficacy of systematic nursing in operating room and routine nursing in reducing intraoperative pressure injury in patients with spine fracture combined with spinal cord injury
Chen Xiaoli, Li Cuicui, Sun Ke, Wang Miao, Si Beibei, Cheng Lan, Li Jing, Li Shuixia
Published 2021-02-15
Cite as Chin J Trauma, 2021, 37(2): 152-157. DOI: 10.3760/cma.j.cn501098-20201015-00636
Abstract
ObjectiveTo compare the effect of systematic nursing in operating room and routine nursing in reducing intraoperative stress injury in patients with spinal fracture and spinal cord injury.
MethodsA retrospective case-control study was conducted to analyze the clinical data of 285 patients with cervical or thoracolumbar fracture associated with spinal cord injury admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University from January 2018 to December 2019, including 168 males and 127 females, with the age of 38-59 years [(47.8±8.5)years]. All patients underwent posterior decompression and fusion with internal fixation. Of all, 138 patients received systematic nursing in operating room including systematic evaluation and management before, during and after operation (observation group), and 147 patients received routine nursing including only intraoperative preventive care of pressure ulcer (control group). The incidence of pressure injury on the day after operation, degree of injury and location of injury at postoperative 3 days, and area of injury on the day after operation and at postoperative 3 days were compared between the two groups. The degree of injury was evaluated using the new stress injury staging assessment published by the American National Pressure Ulcer Advisory Panel (NPUAP).
ResultsThe incidence of pressure injury in observation group [5.1% (7/138)] was lower than that in control group [12.2% (18/147)] on the day after operation (P<0.05). The incidence of stage I, stage II, and stage III pressure injury in observation group [2.9% (4/138), 2.2% (3/138), 0.0%] was also lower than that in control group [8.2% (12/147), 3.4% (5/147), 0.6% (1/147)] at postoperative 3 days (P<0.05). There was no significant difference in the incidence of pressure injury in the knee, chest, face and anterior superior iliac spine between the two groups (P>0.05). The total proportion of pressure injury in the face and anterior superior iliac spine was 71% (5/7) in observation group, showing no significant difference from that in control group [83% (15/18)] (P>0.05). The area of injury was (3.2±1.2)cm2 and (3.2±1.1)cm2 in observation group on the day after operation and at postoperative 3 days, lower than that in in control group [(5.1±1.5)cm2 and (5.1±1.4)cm2] (P<0.01).
ConclusionCompared with the routine nursing, systematic nursing in operating room can significantly reduce the incidence, degree and area of intraoperative pressure injury in patients with spinal fracture accompanied by spinal cord injury, and deserves clinical promotion.
Key words:
Operating room nursing; Pressure ulcer; Spinal fractures; Spinal cord injuries
Contributor Information
Chen Xiaoli
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Li Cuicui
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Sun Ke
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Wang Miao
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Si Beibei
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Cheng Lan
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Li Jing
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
Li Shuixia
First Department of Surgery and Anesthesiology, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, China
