Evaluation of intraoperative pressure injury risk in patients undergoing neurosurgery

This study was conducted as a descriptive study to evaluate the risk of intraoperative pressure injury in patients undergoing neurosurgery. The study was conducted between June 19, 2023 and October 4, 2023, at the Ankara University Faculty of Medicine İbni Sina Research and Training Hospital's Neurosurgery Operating Room with 130 patients who consented to participate in the study. The "Patient Descriptive Characteristics Form" and the Turkish adaptation of the "Munro Pressure Ulcer Risk Assessment Scale", which allows the assessment of pressure injuries in patients undergoing surgery, and the "NPUAP Pressure Ulcers Classification System" was used to determine the presence and degree of pressure injury, were used as data collection tools. The descriptive statistics of the characteristics of patients in the study were evaluated using the mean, standard deviation, minimum, maximum, frequency and percentage. Normal distribution, which is the assumption of parametric analyses, is Kolmogrow Smirnow test, Mann Whitney U t test for pairwise group comparisons, Kruskal Wallis H test for three or more group comparisons, and Mann Whitney U analysis with Bonferroni correction for post hoc analysis was used. Cross-tabulations of categorical variables were evaluated using the Exact Chi-Square test in the SPSS 26 statistical program. p<0,05 was considered statistically significant. When the descriptive characteristics of the patients included in the study were examined, it was determined that more than half were male and 43,8% were 60 years of age and older, and the median Munro scale scores (Median= 31,0) of these patients were significantly higher statistically than other age groups (p<0,0001). It was observed that 2,3% of the patients included in the study had pressure injuries. Stage I pressure injuries were detected in all patients who had pressure injuries. In 3,8% of the other patients, erythema that blanched with pressure was detected. The most common area where pressure injuries were seen was the sacrum/coccyx with 28,6% frequency. It was found that the mean preoperative albumin value of the patients included in the study, which was 38,69 gr/dl (±5,72), created a statistically significant difference in terms of pressure injuries. It was determined that 50,8% of the patients were at medium risk for pressure injury according to the cumulative Munro scale score average, and the average risk score was determined to be 28,69 (±3,55). It was found that all patients who developed pressure injury were at medium risk according to the Munro scale, and the average score of these patients from the Munro scale was 25,00±2,65. The average Munro scale score of the patients who did not develop pressure injury was found to be 28,78±3,53. As a result of this study, it is recommended that the risk of pressure injury be assessed using a scale as the first step in pressure injury prevention in all operating rooms, especially in neurosurgery operating rooms, and that training on pressure injury prevention should be provided not only to nurses but also to the entire healthcare team.