Journal of Wound Care· 2026Q2· Review
Risk factors for pressure ulcer development among adults undergoing surgery: a systematic review
- 1citations
- Q2SCImago
- 2026year
Short summary
A systematic review of 41 studies identified key risk factors for pressure ulcers (PUs) in surgical adults: preoperative (Braden score, age, diabetes), intraoperative (surgery duration, patient positioning, surgery type), and postoperative (Braden score, sepsis, pneumonia). Sepsis and pneumonia were significant in 100% of studies assessing them.
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Key points
- Braden score was a significant preoperative risk factor in 68.8% and postoperative in 83.3% of studies.
- Age (61.3%) and diabetes (61.1%) were significant preoperative risk factors.
- Intraoperative risks included surgery duration (53.6%), patient positioning (60.0%), and surgery type (60.0%).
- Sepsis and pneumonia were identified as postoperative risk factors in 100% of studies that assessed them.
AI-generated from the title and abstract; the full text is not read.
Abstract
OBJECTIVE: To examine risk factors for pressure ulcer (PU) development among adults undergoing surgery. METHOD: A total of five electronic databases were searched from inception to March 2024. Study selection, data extraction and quality appraisal were performed by two independent reviewers, using the Crowe Critical Appraisal Tool (CCAT v1.4; Michael Crowe, James Cook University, Australia), with scores ≥75% indicating high methodological quality. Results were categorised and reported as preoperative, intraoperative and postoperative risk factors, with percentages representing the proportion of studies assessing each risk factor in which it was statistically significant. Due to methodological heterogeneity, findings were synthesised narratively. RESULTS: A total of 41 studies were included, 20 (48.8%) of which had retrospective designs. Among the preoperative risk factors, Braden score was statistically significant in 11 (68.8%) of the 16 studies assessing this factor, age in 19 (61.3%) of 31 studies, and diabetes in 11 (61.1%) of 18 studies. Among intraoperative risk factors, duration of surgery was statistically significant in 15 (53.6%) of 28 studies assessing this factor, patient positioning in nine (60.0%) of 15 studies, and type of surgery in nine (60.0%) of 15 studies. Postoperatively, Braden Scale score was statistically significant in five (83.3%) of six studies, while sepsis and pneumonia were each statistically significant in all three (100%) studies assessing these factors. The mean methodological quality score was 82±9.7%. CONCLUSION: This systematic review identified several risk factors for PU development across the included studies during the preoperative, intraoperative, and postoperative surgical period. Due to the complex interplay between competing factors that impact PU development during surgery, the development of a core outcome set of risk factor variables for inclusion in future studies may enhance homogeneity and support risk stratification alongside optimisation of modifiable exposure factors.
The authors' abstract, as published at the source. Journal of Wound Care, 2026 · DOI ↗
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Field: Occupational Therapy
Occupational TherapyHealth Professions