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Risk Factors for Facial Pressure Ulcers in Patients Underwent Prolonged Prone Orthopedic Spine Surgery.

Abstract：

STUDY DESIGN:Retro-prospective study. OBJECTIVES:To identify the incidence and the risk factors associated with the development of Facial pressure ulcers (FPU) in patients underwent spine surgery in prone position for at least 3 hours. SUMMARY OF BACKGROUND DATA:FPU is a serious complication that can occur after prolonged surgery in the prone position. METHODS:A total of 300 cases were studied (160 retrospective cases and 140 prospective cases). Preoperative, intraoperative and postoperative data were collected using a structured record form. Patients were divided into FPU group and normal group. A univariate and multivariate logistic regression was used to determine the association of predictor variables. RESULTS:FPU occurred in 82 patients (27.3%), 129 zones, and 151 lesions. The average age was 61.9 years (11-89), the average operating time was 3.8 hours (3-8.3). The locations of FPU were the forehead, maxillary and chin zone (33.3, 34.1 and 32.5%, respectively). The severity was mostly stage I or II except one patient who developed stage III on the entire face. Patients in the FPU group had significant difference in: operation time (4.4 h vs. 3.6 h), anesthetic time (5.2 h vs. 4.0 h), hypotension (79% vs. 56%), lowest blood pressure, total blood loss, total crystalloid, colloid and blood replacement, highest temperature (36.5 C vs. 36.2 C compared to the normal group (P < 0.05). Factors related to FPU were hypotension OR 2.75 (95%CI 1.4-5.2, P = 0.002), highest temperature OR 1.95 (95%CI 1.1-3.3, P = 0.013), operation time OR 1.44 (95%CI 1.0-1.9, P = 0.014) and total crystalloid therapy OR 1.07 (95%CI 1.0-1.1, P = 0.042). CONCLUSION:The incidence of FPU after prone spine surgery using head padded device more than 3 h was 27.3%. The risk factors of developing FPU included: hypotension, higher temperature, prolonged operation time and much crystalloid therapy.Level of Evidence: 4.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Techanivate A,Athibai N,Siripongsaporn S,Singhatanadgige W

doi

10.1097/BRS.0000000000003892

subject

Has Abstract

pub_date

2020-12-17 00:00:00

eissn

0362-2436

issn

1528-1159

pii

00007632-900000000-93884

journal_volume

Publish Ahead of Print

pub_type

杂志文章

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Risk Factors for Facial Pressure Ulcers in Patients Underwent Prolonged Prone Orthopedic Spine Surgery.