Pressure in the Operating Room: A Potential Contributor to Hospital-Acquired Pressure Injuries
Bibliographic record
Abstract
Burn patients are at risk for hospital-acquired pressure injuries (HAPIs). An unexamined factor that may contribute to HAPI development is the effect of pressure from the operating table during surgery. The purpose of this study was to measure pressure on the buttocks and sacral area during burn surgery under general anesthesia (GA). Prospective study of consecutive adult burn patients admitted to an ABA-verified burn center who required surgery under GA between January 06, 2022 and December 08, 2022. We studied only cases that were supine, including those with both legs down (LD), one leg suspended (1LU), or both legs suspended (2LU). Interface pressures on the buttocks and sacral area were measured using a commercial sensor mat. Thousands of individual pressure measurements were integrated to show average and peak pressures over repetitive 10-minute intervals during the entire operation. Recordings were completed in 41 procedures among 28 patients (48.3 ± 16.9 years, % TBSA burn 19.2 ± 17.1, weight 80.2 ± 19.7 kg, BMI 26.7 ± 6.2). Both average pressure (Pave) and peak pressure (Ppeak) increased significantly with greater number of elevated legs (p < .001). During 2LU periods, Ppeak exceeded 100 mmHg for almost half the operative duration. Pave crept steadily upwards over time and had a positive relationship with weight, regardless of leg elevation. Prolonged moderate to high pressures are exerted on the sacral and buttock areas, especially with one or both legs suspended, during burn surgery. These novel observations suggest that pressure from the operating table could contribute to HAPI development.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".