Letter to the Editor ‘Best Evidence Summary for the Prevention of Pressure Injuries in Orthopaedic Patients’

It was with great interest that we read the article published in the Journal of Clinical Nursing (Zhou et al. 2024) carried out a thorough search for research on orthopaedic patients in general wards and how to prevent pressure injuries (PIs). The results demonstrated a thorough synthesis of the strongest data for the avoidance of PIs in orthopaedic patients, including 34 pieces of research that can be useful references for clinical practice. Pressure injuries (PIs) are potentially preventable but frequently occurring adverse events. Generally speaking, it is described as localised harm brought on by pressure on a bony prominence or in the deep soft tissues or skin of medical devices that impede blood flow (Li et al. 2020; Lin et al. 2020; Posthauer et al. 2015). With a reported prevalence of 12%–33%, patients in intensive care have significant risk factors for PIs. PIs raise morbidity and mortality, lengthen hospital stays, lower quality of life and raise hospitalisation expenses. To prevent PIs, multifaceted interventions—also referred to as programmes or care bundles—are advised. Numerous risk variables must be taken into account while developing PIs, including procedural aspects like the type of anaesthesia, surgery and its duration, as well as patient-specific factors like age, gender, chronic conditions and nutritional status (Kurt, Kaşikçi, and Malaska 2024). Furthermore, a number of non-patient-related elements, like the location of heaters, operating tables and surgical support equipment, might also be important. Surgery that increases pressure is one of the most important of these causes. According to evidence, the amount of pressure applied and how long it lasts can cause stress on tissues, which can lead to the development of PIs, a common side effect of many surgical procedures. This study set out to thoroughly find, assess and synthesise the strongest data on preventing PIs in orthopaedic patients admitted to general wards. There were limitations. The information compiled in this study can be used as a guide to help orthopaedic patients avoid PIs. First, a narrative review was presented because a meta-analysis was not practical due to the variety of interventions and measures. Furthermore, the included research diverse approaches (sample collection techniques, sample sizes, operating settings, measurement units, etc.) made it difficult to generalise the findings. Some studies also showed a possibility of non-response bias, which could be a drawback because participants who did not reply would be different from those who did. Readers should therefore select the most trustworthy evidence with care and consideration. Furthermore, it is crucial to understand that the best evidence summary is subject to constant change; thus, researchers must update it on a regular basis. Additionally, only research involving orthopaedic patients was included in this evaluation. Generalisation to additional aspects is impossible due to strict inclusion constraints. Future high-quality studies, such as randomised controlled trials, are necessary to evaluate the efficacy of multicomponent therapies and the methods used to administer them. The authors have nothing to report. The authors declare no conflicts of interest. The authors have nothing to report.