Retrospective review of predisposing factors for intraoperative pressure ulcer development

Study ObjectiveTo evaluate the comorbidities and surgical factors involved in the genesis of intraoperative pressure ulcers.DesignRetrospective chart review.SettingAnesthesiology department of a university medical center.MeasurementsThe charts of 222 patients with varying illness, who underwent an operation of at least two hours’ duration, were analyzed retrospectively. Data on surgery type, case length, comorbidities, intraoperative surgical position, and area of ulceration were recorded.Main ResultsRisk factors for intraoperative pressure ulcer development include surgical times of 4 hours or longer; comorbidities affecting tissue perfusion (namely, diabetes, hypertension, and nonspecific cardiac issues); supine placement during surgery; and abdominal, noncardiac thoracic, and orthopedic operations. Regions of the body most at risk for ulceration include the coccygeal/sacral region, the buttocks, genitalia, and heels.ConclusionsPressure ulcers are a costly, debilitating, and avoidable complication of surgery.