Authors (including presenting author) :
Lam PY(1)(2), Wong TS(1)(2), Lui ML(1)(2)
Affiliation :
(1)Operating Theatre, Department of Anaesthesia,(2)Pamela Youde Nethersole Eastern Hospital
silicone foam dressing
Introduction :
OT-acquired Pressure Injuries (OAPIs) had been consistently monitoring in our department since 2013. However, the preventive strategies still remain a crucial clinical challenge especially for those patients undergoing spinal surgery; that has been identified in our prevalence survey. We therefore, sought to reduce the pressure injury prevalence by implementing a continuous quality improvement project.
Objectives :
We aim to (1)analyze the available research on the effectiveness of prophylactic foam dressing application to prevent OAPI, thus providing an evidentiary support for the later clinical study; and (2)investigate the effectiveness of a 5-layer silicone foam dressing applied to the potential pressure areas of patients undergoing spinal surgery with prone position.
Methodology :
Phase 1: We conducted a literature review and searched from CINAHL, EMBASE and HA e-Learning within 12 years for randomized controlled trials on the effectiveness of prophylactic foam dressing application to prevent OAPI, published in English and involving elective surgery patients aged 18 years or older.
Phase 2: We then carried out a pre-/post-intervention design, quality improvement project in a convenience sample of 40 patients undergoing spinal surgery.
Result & Outcome :
Phase 1: The results suggested that the prophylactic foam dressing application could be an effective measure to prevent OAPI in perioperative setting.
Phase 2: A total of 40 patients undergoing elective spinal surgeries in prone position participated in this project. 20 patients were in the pre-intervention group who were identified from the in-house pressure injury prevalence data from 1 Jan 2018 to 31 Aug 2018 and received standard pressure injury prevention during surgery. 20 patients in the intervention group were identified prospectively from the Operating Theatre Monitoring System (OTMS) and pre-operatively received the 5-layer silicone foam dressing in addition to standard care. Data were collected immediately after surgery and after 24 hours via medical records. A total of 45% (n=9) in the pre-intervention group had developed pressure injuries and only 5% (n=1) in the intervention group developed pressure injuries. The incidence rate of OAPI decreased by 88.9%. These findings suggest the effectiveness of 5-layer silicone foam dressing when added to standard preventive interventions.
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