At the Heart of the Problem

Cardiac Patients at High Risk for Pressure Injury Development

Pressure injuries can occur following surgery. One study estimated the incidence rate to be around 15%. But in the post-cardiac population, that percentage doubled to nearly 30%

According to the Society of Thoracic Surgeons, approximately 24,000 cardiac surgeries were performed monthly in 2019. That’s nearly 300,000 in the last ‘normal’ year.  And while COVID-19 skewed the data for the last few years, at the end of the day, there are a lot of heart surgeries performed in the US. So, what effect are all these surgeries having on the skin? A lot!

Pressure injuries can occur following surgery. One study estimated the incidence rate to be around 15%. But in the post-cardiac population, that percentage doubled to nearly 30%. Why? While clinical studies are slim, it is known that cardiac patients pre-, mid- and post-surgery endure many factors that intrinsically increase the potential for skin breakdown. 

The answers may rest with a patient’s tissue tolerance. As with most surgical patients, cardiac patients experience pressure and shearing forces during their procedures. But the average length of time for most heart surgeries rests between 3 and 4 hours, which on its own can gravely affect the skin. Any surgery lasting longer can further complicate the patient’s tissue tolerance for pressure. Vascular issues resulting in the need for vasopressors post-surgery can significantly reduce the tissue tolerance for oxygen in cardiac patients. Two big strikes against an already vulnerable population. 

On a granular level, the potential for severe complications following heart surgery, such as sepsis or infection, may also contribute to the prevalence of pressure injuries. While further research is truly needed to identify why the risk is so high for cardiac patients, what the studies do indicate is the dire need for better prevention

If adverse effects are rising, then change is required. It’s common sense. If cardiac patients are experiencing a higher-than-average risk for pressure injuries, then change is required. Prevention strategies targeted at tissue tolerance issues are great starting points. Measures specifically addressing temperature and blood pressure are imperative for positive patient outcomes. And pressure-relieving surfaces that can accompany the cardiac patient throughout the surgical journey check the box on tissue tolerance for pressure. The risk is there; the solution is to stop the pressure injuries before they start.

While more research is required and no one method is going to single-handedly eradicate pressure injuries in cardiac patients, it doesn’t hurt to step up prevention. Sometimes the smallest change makes the biggest impact. Cardiac surgery is clearly not for the faint of heart. Click here for a deeper dive into proven pressure injury prevention solutions. 

https://www.sts.org/publications/sts-news/pandemic-slows-down-heart-surgery-cuts-volume-half#:~:text=The%20group%20examined%20information%20on,month%20in%20the%20United%20States

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948616/pdf/IWJ-16-9.pdf