Risk and incidence of pressure wounds during perioperative period in patients undergoing hip replacement

Abstract

Introduction: Hip replacement is a surgical method for treatment of hip osteoarthritis and traumas resulting in femoral neck fracture. Pressure wounds developing during perioperative period may constitute a significant medical problem at orthopaedic wards and may require preventive and therapeutic measures, to be performed by interdisciplinary teams. The aim of the study was to assess the selected risk factors in terms of their relationship to pressure wound incidence during perioperative period in patients undergoing hip replacement. Materials and methods: The proper part of the study involved 105 patients, aged 42-90 years, who received hip replacement operation and met inclusion criteria. Methods of observation and estimation were used in combination with a specially designed study protocol in order to collect information about patients and their condition, taking into account medical history, as well as measurements and observation carried out by nursing personnel, the latter performed in two stages, prior to and over 24 hours after an intervention. Results: The risk of pressure wounds developing before the operation was identified in 41% of the subjects, and pressure wounds developed in 11.4% of the patients. During the post-operative period all the patients were found to be at risk of pressure wounds. The assessment after the intervention showed stage I/II pressure wounds in 32.4% of the subjects. Majority of the patients in this group (91.2%) were found with stage I and 8.8% of the subjects developed stage II pressure wounds; these were most frequently located in the sacral area (55.9%) and calcaneus region (44.1). Conclusions: The "emergency" mode of the intervention and a waiting time before the operation exceeding 48 hours determine the risk of post-operative pressure wound development. The risk and incidence of pressure wounds were increased by such factors as: age over 70 years, female sex, anaemia, and a risk of thromboembolism.