Development of a predictive index for pressure ulcers using an analysis of factors affecting intraoperative pressure ulcer formation and body pressure load

Research Project

Project/Area Number	17H07310
Research Category	Grant-in-Aid for Research Activity Start-up
Allocation Type	Single-year Grants
Research Field	Clinical nursing
Research Institution	Fukuoka Nursing College
Principal Investigator	SOUHEI UCHIDA 福岡看護大学, 看護学部, 教授 (00807109)
Project Period (FY)	2017-08-25 – 2019-03-31
Project Status	Completed (Fiscal Year 2018)
Budget Amount *help	¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000) Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000) Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Keywords	鏡視下・ロボット手術 / 術中褥瘡 / 手術体位 / 複合傾斜 / 予測指標 / 褥瘡予防 / 鏡視下手術 / 複合傾斜角 / 褥瘡予測指標 / 連続複合斜角 / 褥瘡形成要因 / 体圧加重変化
Outline of Final Research Achievements	A predictive index was developed with the aim of preventing intraoperative compression sores. The basic index was developed by comparing the incidence of pressure ulcers to factors affecting pressure ulcer formation, i.e., duration of surgery, basic body position, anesthesia, degree of obesity, age, transfusions, total serum protein level, and the pressure ulcer incidence rate based on the American Society of Anesthesiologists classification. Load risk criteria were developed by calculating the critical values of body pressure load and stress at various tilted positions. The risk of pressure ulcers was assessed by calculating the sum of the score calculated according to the factors of the basic index obtained from preoperative data and the load risk criteria at the maximum planned tilt angle . Quantifying the risks of pressure ulcers in preoperative assessments facilitates implementation of effective preventive measures based on the risks.
Academic Significance and Societal Importance of the Research Achievements	医療機器の進歩と外科医の技術の向上により、鏡視下・ロボット手術の増加し、複雑な体圧荷重がかかる複合傾斜位が標準化しており、頻回かつ高度な傾斜変化に伴う体圧荷重部位の広範囲かつ集中化により、術中褥瘡予測が困難となっている。褥瘡対策は必須条件であり、医療の質保証の1つとして位置づけられている。よって術中褥瘡を予防するため、危険度を予測する指標が必要である。