Pressure ulcers are lesions of ischemic hypoxic injury caused by long-term compression of local skin tissue, and the pressure ulcers caused by posture rank fourth among the safety risks in operating room. Because of the small bearing area and the large pressure, plus the longer operation time, patients with spinal operation at prone posture are more likely to suffer from pressure ulcers, especially for patients over 65 years old with obesity, weakness and marasmus, etc., their tolerance of the forced posture for surgery is poor, so intraoperative pressure ulcers are more likely to occur.
1. The effects of foam dressing
The pressure ulcer is a common complication of surgery, especially during the hospitalization of orthopedic patients, its occurrence not only brings pain to patients, but also extends patients' hospital stay obviously, which increases the economic burden. Because patients undergoing posterior spinal surgery are under general anesthesia, their muscles are relaxed and the protective reflex is lost, and they are in a fixed position for a long time, the intraoperative pressure ulcers are more likely to occur. Intraoperative pressure ulcers refer to the pressure ulcers occurred in patients within a few hours to six days after surgery, most of which occurred in one to three days after the operation. Therefore, we apply silicone foam dressing with border plus gel pads to patients with surgery time more than 3 hours, the experimental results show that the application of this method has obvious effect on the protection of pressure ulcers in surgical patients: The incidence of pressure ulcers fell from 26.6% to 6.6%. The principle of skin protection is that the main component of foam dressing is fatty acid peroxide ester, which can have a similar effect to cyclic prostaglandins through molecular replacement; inducing vasodilation, promoting skin microcirculation, and increasing local oxygen saturation and partial pressure after using.
Gel pads have high absorption and vibration reduction ability, can distribute the pressure of weight and prevent the characteristic of pressure concentration, and have the softness similar to human soft tissue, and have good histocompatibility characteristics, can reduce the shear and friction force at the pressure parts, change the skin oxygen partial pressure, and improve the local blood supply oxygen, so as to achieve the protective effect.
2. Foam dressings increase the compression capacity of pressure parts as a method
As a physical method, gel pads reduce the stimulation of pressure aeras by external force, the combination of silicone foam wound dressings has obvious effects on the protection of pressure ulcers in surgery patients. At the same time, it is suggested that the position of silicone foam wound dressings should be pasted accurately, otherwise the desired effect cannot be achieved. The clinical application of gel pads and foam dressings in the prevention of pressure ulcers in posterior spinal surgery patients is simple and worth the clinical promoted use.