The effect of gel foam mattress use during total hip replacement surgeries on the development of pressure ulcers in the recovery unit: a quasi-experimental study

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Büşra Şahin
Rahşan Çam


Objective:  This study was conducted on patients undergoing total hip replacements in order to examine the effect of the use of a gel foam mattress during surgery on preventing the development of pressure ulcers.

Material and Method: A quasi-experimental design, with a pretest-posttest control group, was used for this study, which was carried out in the Orthopedics and Traumatology Clinic of the Adnan Menderes University Research and Treatment Hospital between July 2015 with 80 patients who were to undergo total hip replacement surgery (40 in the experimental group and 40 in the control group who were to undergo total hip replacement surgery and April 2016.

Results: According to the research results, 30% of the patients in the experimental group and 60% of the patients in the experimental group developed pressure ulcers in the recovery unit (p=0.013). It was further observed, according to the results of Braden Pressure Ulcer Risk Assessment Scale (BPURAS), that the type of pressure ulcers in the patients who developed them was stage 1 and located in the gluteal region.

Conclusion: Our results have been shown that the development of pressure ulcers in patients from both the experimental group and the control group in the recovery unit was related to age, operating time (min), anesthesia type, while height, weight, gender, diagnosis, temperature of operating theater. However, movement restrictions before surgery have not an impact on the development of pressure ulcers.


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Şahin, B. ., & Çam, R. . (2018). The effect of gel foam mattress use during total hip replacement surgeries on the development of pressure ulcers in the recovery unit: a quasi-experimental study. Medical Science and Discovery, 5(11), 361–367. Retrieved from
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1. Gökçe H, Altunkılıç T, Serbest S. Total Hip Prosthesis Results. Journal Of Clinical and Analytical Medicine 2014;5(3).doi: 10.4328/JCAM.2403
2. Minnesota Hospital Association. Pressure Ulcer Prevention in the O.R Recommendations and Guidance, Patient Safety 2013.
3. Prevention and Treatment of Pressure Ulcers: Quick Reference Guide, 2014. Available from: 10.12.2017.
4. Murphy RA, Patel KV, Kritchevsky SB, et al. Weight change, body composition, and risk of mobility disability and mortality in older adults: a population-based cohort study. Journal American Geriatics Society.2014; 62:1476–1483. Doi: 10.1111/jgs.12954.
5. Yavuz M. Support surfaces in prevention and treatment of pressure wounds. Turkish Society of Surgery and Nursing. 2007; 134-150.
6. Cuddigan J, Ayello EA, Sussman C, Baraoski S. Pressure ulcers in America: prevalence, incidence, and implications for the future. Reston, VA: NPUAP; 2001.
7. Karadağ M, Gümüşkaya N. The incidence of pressure ulcer in surgical patients: a sample in Turkey. Journal of Clinical Nursing. 2005, 15, 413-421.doi: 10.1111/j.1365-2702.2006.01369.x
8. Schoonhoven, L., Defloor, T., van der Tweel, I., Buskens, E., & Grypdonck, M. H. Risk indicators for pressure ulcers during surgery. Applied Nursing Research.2002;15(3), 163-173. doi: 10.1053/apnr.2002.34145
9. Rastinehad, D. Pressure ulcer pain. Journal of Wound Ostomy & Continence Nursing. 2006; 33(3), 252-257.
10. Gorecki C, Brown JM, Nelson EA, Briggs M, Schoonhoven L, Dealey C, et al. Impact of pressure ulcers on quality of life in older patients: a systematic review. Journal American Geriatics Society. 2009; 57:1175-83. doi: 10.1111/j.1532-5415.2009.02307.x.
11. Mistiaen P, Francke A, Achterberg W, Ament A, Halfens R, Huizinga J. Australian Medical Sheepskin is effective for the prevention of pressure ulcers.Tijdschrift voor Ouderengeneeskunde.2009;5:186–90.
12. Brienza D, Kelsey S, Karg P, Allegretti A, Olson M, Schmeler M, Zanca J, Geyer MJ, Kusturiss M, Holm M. A randomized clinical trial on preventing pressure ulcers with wheelchair seat cushions. Journal American Geriatics Society. 2010;58(12):2308–2314. doi: 10.1111/j.1532-5415.2010.03168.x.
13. Donnelly J, Winder J, Kernohan WG, Stevenson M. An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture. Journal of Wound Care. 2011;20(7):309–318.doi: 10.12968/jowc.2011.20.7.309
14. Ricci E, Roberto C, Ippolito A, Bianco A, Scalise MT. A new pressure-relieving mattress overlay. European Wound Management Association Journal. 2013;13(1):27–32.
15. Cavicchioli A, Carella G. Clinical effectiveness of a low-tech versus high-tech pressure redistributing mattress. Journal of Wound Care. 2007;16(7):285–9. Doi: 10.12968/jowc.2007.16.7.27060
16. Botella-Carretero, J. I., Iglesias, B., Balsa, J. A., Arrieta, F., Zamarrón, I., & Vázquez, C. Perioperative oral nutritional supplements in normally or mildly undernourished geriatric patients submitted to surgery for hip fracture: a randomized clinical trial. Clinical Nutrition. 2010; 29(5), 574-579. doi: 10.2147/CIA.S74951
17. Jolley DJ, Wright R, McGowan S, Hickey MB, Campbell DA, Sinclair RD, et al. Preventing pressure ulcers with the Australian Medical Sheepskin: an open-label randomised controlled trial. Medical Journal of Australia. 2004;180(7): 324–7.
18. Brito, P. A., de Vasconcelos Generoso, S., & Correia, M. I. T. D. Prevalence of pressure ulcers in hospitals in Brazil and association with nutritional status—a multicenter, cross-sectional study. Nutrition.2013; 29(4), 646-649. doi: 10.1016/j.nut.2012.11.008.
19. Stoelting, J., McKenna, L., Taggart, E., Mottar, R., Jeffers, B. R., & Wendler, M. C. Prevention of nosocomial pressure ulcers: a process improvement project. Journal of Wound Ostomy & Continence Nursing. 2007;34(4), 382-388.
20. Wound Diagnosis and Follow-up Form. Available from:
21. Jönsson, A. C., Lindgren, I., Hallström, B., Norrving, B., & Lindgren, A. Determinants of quality of life in stroke survivors and their informal caregivers. Stroke. 2005; 36(4), 803-808. Doi: 10.1161/01.STR.0000160873.32791.20
22. Jerusum ve ark. Balloons, beds and breakdown. Critical Care Nursing North America. 1996,8,423-44. DOI: 10.1016/j.cnc.2017.06.001
23. Totur B. Investigation of the Efficiency of Using Air Beds with 100% Cotton Towels in Prevention of Other Wounds, Ege University Institute of Health Sciences, Published Master Thesis, İzmir, 2006.
24. Hoshowsky VM, Schramm CA. Intraoperative pressure sore prevention: an analysis of bedding materials, Research in Nursing & Health.1994, 17,333-39.
25. Schultz A, Bien M, Dumond K, Brown K, Myers A. Etiology and incidence of pressure ulcers in surgical patients. AORN Journal. 1999;70(3):434, 437-40, 443-9. doi:10.1111/j.1524-475X.2009.00462.x 26. Schoonhoven L, Defloor T, Tweel I, Buskens E, Grypdonck MH. Risk indicators for pressure ulcers during surgery. Applied Nursing Research.2002;16(2),163-173.
27. Chalian AA, Kagan SH. Backside first in head and neck surgery? preventing pressure ulcers in extended length surgeries. Head & Neck.2001, 23: 25-28.
28. Defloor T, Schuijimer D. An evalution of four operating table mattresses used for preveting pressure ulcers. Applied Nursing Research. 2000,13,3,134-141. DOI: 10.1053/apnr.2000.7653.
29. Nixon J. Cranny G, Iglesias C, Nelson EA, Hawkins K, Philips A. ve ark. Randomised controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers. British Medical Journal. 2006; 1-5. DOI: 10.1136/bmj.38849.478299.7C.
30. Bodavula P, Liang SY, Wu J, VanTassell P, Mar- schall J. Pressure ulcer-related pelvic osteomyelitis: a neglected disease? Open Forum Infect Disease. 2015;2:ofv112. Doi:10.1093%2Fofid%2Fofv112
31. McInnes E, Jammali-Blasi A, Bell-Syer SE, Dum- ville JC, Middleton V, Cullum N. Support surfaces for pressure ulcer prevention. Cochrane Database Syst Rev. 2015; 9:CD001735. Doi: 10.1002/14651858.CD001735.pub5.
32. Gould L, Abadir P, Brem H, et al. Chronic wound repair and healing in older adults: current status and future research. Wound Repair Regen. 2015;23:1–13. Doi:10.1111/wrr.12245