Postoperative Pressure Injury in Patients Undergoing Prone Spinal Surgery

Study Overview
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Brief Summary
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Patients undergoing surgery under general anesthesia are susceptible to pressure-induced soft tissue damage because there is no change in posture over an extended period of time. In particular, when the patient is in a prone position, unlike the supine position, the bony protruding portion of the front side must support the weight, which is more vulnerable to pressure injury. Previous studies have shown that the incidence of pressure injury during surgery varied from 5% to 66% and was more likely to occur in patients with long operating times, prone position, obesity, and poor skin condition. These pressure injuries increase postoperative complications, length of stay, and medical costs. Therefore, the investigators analyze the incidence of pressure injury in prone position and re-examine the risk factors of pressure injury.

Detailed Description
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All of the anesthetic and surgical procedures performed on the subject during the period from the time the subject enters the operating room to the time the subject go to the recovery room are the same as those for the existing spine surgery. Immediately after entering the operating room, immediately before going to the recovery room, and at postoperative day 1 and 2, the patient's systemic skin condition is assessed to determine whether pressure damage has occurred. The primary endpoint is the incidence of pressure injury in the subject compared with the incidence of pressure injury in previous studies. To identify the risk factors for the occurrence of pressure injury, the investigators will statistically analyze the data collected with the assumption that this is related.

Official Title
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Incidence and Risk Factors of Postoperative Pressure Injury in Patients Undergoing Prone Spinal Surgery

Conditions
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Pressure Injury

Intervention / Treatment
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* Procedure: Prone spinal surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults patients undergoing elective spine surgery in prone position under general anesthesia Exclusion Criteria: Pre-existence of pressure injury

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 79 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Patients undergoing prone spinal surgery<br>Patients undergoing elective spinal surgery in prone position under general anesthesia, which is performed by neurosurgeons in Seoul National University Hospital | Procedure: Prone spinal surgery<br>* spinal surgery in prone position under general anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of pressure injury | The pressure injury after prone spine surgery will be identified and evaluated using Pressure injury staging illustration - National Pressure Ulcer Advisory Panel at end of surgery, postoperative day 1 and 2. The prevalence of pressure injury will be calculated by dividing the number of patients with pressure injury by the total number of patients. | From end of surgery to postoperative day 2 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Site of pressure injury | The pressure injury after prone spine surgery will be identified and evaluated using Pressure injury staging illustration - National Pressure Ulcer Advisory Panel at end of surgery, postoperative day 1 and 2. The site of pressure injury will be categorized as head, chest, abdomen, arm, leg and others. | From end of surgery to postoperative day 2 | 
| Grade of pressure injury | he pressure injury after prone spine surgery will be identified and evaluated using Pressure injury staging illustration - National Pressure Ulcer Advisory Panel at end of surgery, postoperative day 1 and 2. The grade of pressure injury will be categorized as 1, 2, 3, and 4 according to the definition in Pressure injury staging illustration - National Pressure Ulcer Advisory Panel. | From end of surgery to postoperative day 2 |