Investigation of Surgical Position and Medical Device-Related Pressure Injury Risk in Elderly Surgical Patients Recovering in the Postanesthetic Care Unit.

PURPOSE: This study aimed to determine the risk and contributing factors of pressure injuries related to surgical positioning and medical devices in older adults in the postanesthetic care unit (PACU). DESIGN: A descriptive cross-sectional design guided this project. The study was based on the clinical question: What are the risk levels and contributing factors for positioning- and device-related pressure injuries in older PACU patients? METHODS: The study was conducted between November 2024 and May 2025 with 150 patients aged 60 years and older who underwent general anesthesia for surgeries lasting longer than 60 min. Risk levels were assessed using the Braden Scale, the Risk Assessment Scale for Surgical Positioning, and the Medical Device-Related Pressure Injury Risk Scale (ELPO). Assessments were performed at admission to PACU, post-extubation, and before discharge. Demographic, clinical, and perioperative data were also analyzed to identify contributing risk factors. FINDINGS: Sixty-one percent of patients were at high risk for positioning-related pressure injuries, especially those aged 65-84 and smokers. Abdominal and orthopedic surgeries were the most common procedures. Additionally, 28% of patients were at high risk for medical device-related pressure injuries. Although risk levels decreased after extubation, they remained high in patients who required prolonged mechanical ventilation or inotropic support. Advanced age, smoking status, duration of ventilator use, and the need for inotropic therapy were identified as significant contributors to increased risk. CONCLUSIONS: Older PACU patients are at substantial risk for positioning- and device-related pressure injuries, especially when additional clinical factors are present. Early identification and proactive prevention strategies are essential to reduce risk in this population. Future studies should evaluate the effectiveness of targeted preventive interventions and integrate standardized risk assessment tools into routine PACU practice.