Incidence of facial pressure ulcers following surgery in the prone position - experience in a tertiary care hospital in Singapore

Introduction: The development of facial pressure ulcers after prone positioning is a well-known complication and a common source of patient dissatisfaction. Several risk factors have been identified in past studies. However, few studies have focused on the Asian population. We therefore set forth to identify the incidence of facial pressure ulcers following surgery in the prone position in our local population, as well as determine possible risk factors for their development.

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Methods: We recruited 132 patients who underwent elective surgery in a prone position under general anaesthesia in our tertiary hospital. The occurrence of facial pressure ulcers was analysed against several demographic and intraoperative factors. Statistical significance was taken as p<0.05.

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Results: A total of 114 patients were included in the final analysis. The overall incidence of facial pressure ulcers was 35%. The most common locations were the cheeks (75%), and the forehead (43%). Increased age (OR 1.04 per year, p=0.035) and a prolonged duration of surgery (OR 2.05 per hour, p<0.001) were both significantly associated with facial pressure ulcers.

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Conclusion: Facial pressure ulcers are common following surgery in a prone position in our local context. This first study on the Southeast Asian population corroborates with known risk factors for pressure ulcer development. Future studies may explore possible risk reduction measures to reduce the incidence of facial pressure ulcers in Southeast Asian populations