The Risk Factors of Postoperative Pressure Ulcer After Liver Resection With Long Surgical Duration

A Retrospective Study

Hong-Lin Chen, MD; Ai-Gui Jiang, MD; Bin Zhu, MD; Ji-Yu Cai, MM; Yi-Ping Song, MM


Wounds. 2019;31(9):242-245. 

In This Article


Patient Characteristics

Between January 2015 and December 2016, 152 patients had a liver resection with a surgical duration greater than 2 hours. Of those, 24 patients were missing PU data and excluded. After exclusion, 128 patients were included in this study. Patient age ranged from 35 to 78 years with a mean age of 61.6 ± 9.5 years. The mean admission Hb was 114.0 ± 14.2 g/L, and the mean admission Alb was 31.0 ± 3.3 g/L. Fifteen patients (11.7%) had DM. The mean surgical duration was 154.2 ± 34.4 minutes, and the mean intraoperative blood loss was 257.3 ± 195.3 mL. The baseline characteristics of the included patients are listed in Table 1.

Postoperative PU

Of the 128 patients, 11 developed a PU. The postoperative PU incidence was 8.6% (95% CI, 4.4%–14.9%). All PUs developed within 3 days after liver resection surgery; 2 PUs developed in the first day after surgery, 6 on the second day, and 3 on the third day. Of the 11 PUs, 7 were on the sacrum and coccyx and 4 were in the ischial tuberosities. All PUs were classified as stage 1. When PUs developed, patients received a pressure-relief mattress, hydrocolloid dressing, and repositioning assistance every 2 hours for treatment. All PUs healed 2 to 5 days after initiation of treatment; healing was determined by visible evidence of the wound covered by skin.

Risk Factors for Postoperative PU

Of the 11 patients with a PU and the 117 without, the characteristics of patient age, BMI, and admission Hb were not significantly different between the 2 groups (P > .05). However, admission Alb, DM status, length of surgery, and intraoperative blood loss were significantly different between the 2 groups (P < .05). The baseline characteristics comparison between the 2 groups are shown in Table 1.

Admission Alb, DM status, intraoperative blood loss, and length of surgery were further analyzed by multivariate logistic regression. After regression analysis, only length of surgery (odds ratio [OR] = 1.008; 95% CI, 1.002–1.146) and intraoperative blood loss (OR = 1.005; 95% CI, 1.001–1.124) were the independent risk factors for postoperative PU of this patient population. The logistic regression analysis is listed in Table 2.