Effect of different positioning before, during and after surgery on pressure injury: a randomized controlled trial protocol

Bedia Guler, Aysel Gurkan
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Abstract

Background: Patients undergoing surgery are at risk of developing pressure injuries because they remain immobile and in a fixed position on the operating table for a long time under anesthesia. Prevention of surgery-induced pressure injuries is the best strategy and requires risk assessment and timely implementation of preventive interventions. This trial aims to evaluate the effect of positioning in a different position pre-operatively and post-operatively than the position adopted during surgery on pressure injuries. Methods: This trial was designed as a prospective randomized controlled study. Participants meeting the inclusion criteria will be assigned to the intervention or control groups using a random number generator. The participants in the intervention group will be placed in different positions than their surgical position during the night before surgery, and the first 36 h after surgery. The control group will receive only routine care. The groups will be evaluated in terms of pressure injury development for at least 72 h, until discharge. Conclusions: Surgery-induced pressure injuries have important effects on patients, healthcare professionals, and healthcare organizations. Current guidelines recommend that patients be positioned in a different position preoperatively and postoperatively than the surgical position to redistribute the pressure generated during surgery. There is a need for well-designed, comprehensive studies to investigate the effectiveness of this weak evidence-level recommendation. This trial will provide valuable evidence to inform clinical practice, guide surgical nurses, and allow evaluation of the effects of this intervention. Trial registration: Clinical trials registration number NCT05549830
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手术前、手术中和手术后不同体位对压力损伤的影响:随机对照试验方案
背景:接受手术的患者由于在麻醉状态下长时间在手术台上保持固定姿势而无法移动,因此有发生压力损伤的风险。预防手术引起的压力损伤是最佳策略,需要进行风险评估并及时实施预防性干预措施。本试验旨在评估术前和术后采用不同于手术时的体位对压力损伤的影响:本试验设计为前瞻性随机对照研究。符合纳入标准的参与者将通过随机数字生成器被分配到干预组或对照组。干预组的参与者将在手术前一晚和手术后的前 36 小时内被置于与手术体位不同的体位。对照组只接受常规护理。干预组和对照组将在至少 72 小时内对压力损伤的发展情况进行评估,直至出院:结论:手术引起的压力损伤对患者、医护人员和医疗机构都有重要影响。现行指南建议,患者术前和术后的体位应与手术体位不同,以重新分配手术过程中产生的压力。有必要进行精心设计的综合研究,以调查这项证据不足的建议的有效性。这项试验将为临床实践提供有价值的证据,为手术护士提供指导,并对这种干预措施的效果进行评估:临床试验注册号:NCT05549830
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