The Impact of a Multidimensional Intraoperative Pressure Injury Prevention Protocol on Postoperative Pressure Injuries Incidence in Elderly Patients Undergoing Internal Fixation for Hip Fracture

Abstract

AIM: To retrospectively analyze the comparative effectiveness of a multidimensional intraoperative pressure injury prevention protocol versus routine nursing care in elderly patients undergoing internal fixation for hip fracture, by comparing the incidence of postoperative pressure injuries, patient satisfaction, and clinical outcomes, to provide evidence-based reference for clinical nursing decision-making.METHODS: A retrospective analysis was conducted by reviewing the medical records of elderly patients who underwent internal fixation for hip fracture during the same period. Based on the actual nursing protocol implemented clinically, patients were categorized into two groups: an observation group, which received the multidimensional intraoperative pressure injury prevention protocol (n = 96), and a conventional group, which received standard pressure injury care (n = 104). The pressure injury incidence on postoperative day 7, hospitalization duration, and medical expenses constituted the primary endpoints; the secondary measures included inflammatory factors (C-reactive protein [CRP], Interleukin-6 [IL-6]), oxidative stress indexes (Malondialdehyde [MDA], Superoxide dismutase [SOD]), and functional recovery parameters (hip joint mobility, muscle strength).RESULTS: The 7-day incidence of postoperative pressure injuries was lower in the observation group than in the conventional group (p < 0.05). Shorter hospital stays, and lower medical expenses were observed in the observation group (p < 0.05), while patient satisfaction was also evaluated as a secondary clinical outcome. At 72 h post-operation, CRP, IL-6, and MDA were significantly reduced, while SOD activity was significantly elevated in the observation group compared with the conventional group (p < 0.05); no significant intergroup differences in these indicators were observed at 24 h post-operation (p > 0.05).CONCLUSIONS: The multidimensional intraoperative pressure injury prevention protocol, which integrates preoperative accurate assessment and intraoperative dynamic mechanical intervention, is associated with a significantly lower incidence of postoperative pressure injuries, shorter length of hospital stay, and lower medical costs in elderly patients with hip fractures undergoing internal fixation.