JCNRJournal of Clinical and Nursing Research2208-36852208-3693Bio-Byword Scientific Publishing Pty. Ltd.10.26689/jcnr.v10i1.13773ArticleCurvilinear Supine Position for Pressure Injury Prevention in Pediatric Cardiac Surgery Patients: A Randomized Controlled Trialhttps://artdesignp.com/journal/JCNR/10/1/10.26689/jcnr.v10i1.13773YangQianxue,XiaoXiuli,XingMinzhe,QinShuo,LiXian20261012026-02-09Background: Pressure injury (PI) is a prevalent complication in pediatric cardiac surgery, with higher incidence than in general pediatric populations due to children’s thin skin, underdeveloped subcutaneous tissue, and prolonged intraoperative pressure. Objective: To evaluate the effectiveness of the curvilinear supine position (CSP) in preventing PI among children undergoing congenital heart disease (CHD) surgery. Methods: Between October 2024 and February 2025, a single-center randomized controlled trial was conducted. Of the 80 children initially enrolled for congenital heart disease (CHD) surgery, 77 (aged 1 month to 14 years) completed the study and were included in the final analysis after 3 were excluded due to protocol violations. Participants were randomly assigned to the CSP group (n = 38) or the conventional supine position group (n = 39). Results: The incidence of PI was significantly lower in the CSP group (2.6%) compared to the control group (20.5%) (p = 0.029). Postoperative LDH levels were also significantly reduced in the CSP group (422.67 ± 86.52 U/L vs. 592.92 ± 215.71 U/L; p = 0.031), while preoperative LDH and surgical variables (e.g., cardiopulmonary bypass time) were comparable between groups. Although the CSP group had a shorter hospital stay (17.24 vs. 22.51 days), the difference was not statistically significant (p = 0.085). Caregiver satisfaction was significantly higher in the CSP group (100.0% vs. 84.6%; p = 0.025). Conclusion: CSP effectively reduces PI incidence, mitigates tissue injury, and enhances caregiver satisfaction in pediatric cardiac surgery, offering a safe and feasible strategy for perioperative PI prevention.

Liu J, Zhao T, Yu Y, 2020, Research Progress on Risk Factors of Intraoperative Pressure Injuries in Patients Undergoing Cardiopulmonary Bypass Surgery. Chinese Journal of Clinical Nursing, 12(2): 175–178.

Zhang P, Tian Y, Tao F, et al., 2024, Best Evidence Summary for Prevention and Nursing Care of Intraoperative Acquired Pressure Injuries in Neonates. Chinese Journal of Nursing, 59(10): 1233–1241.

Wang Z, Wang X, Zhang W, 2023, Risk Factors for Intraoperative Acquired Pressure Injuries in Pediatric Patients: A Meta-Analysis. Evidence-Based Nursing, 9(14): 2488–2493.

Taghilooh H, Ebadi A, Saeid Y, et al., 2023, Preventing Pressure Injury in Open-Heart Surgical Patients: A Systematic Review. Health Science Reports, 6(3): e1148.

Kulik L, Hasbani N, Stellar J, et al., 2019, Hospital-Acquired Pressure Injuries in Children with Congenital Heart Disease: Prevalence and Associated Factors. Pediatric Critical Care Medicine, 20(11): 1048–1056.

Jing L, Zou A, Jiang W, 2023, Advances in Nursing Care for Intraoperative Pressure Injuries in Cardiac Surgery Patients. Chinese Health Standard Management, 14(2): 195–198.

Chen X, Ma J, Wang F, et al., 2024, Effect of Operating Room Mnemonic-Based Project Management on Preventing Intraoperative Acquired Pressure Injuries in Orthotopic Liver Transplantation Patients. Chinese Journal of Clinical Nursing, 16(3): 171–174.

Zhao K, Zhao T, Li Y, et al., 2017, Application of Curvilinear Supine Surgical Positioning for Prevention of Intraoperative Pressure Ulcers. Chinese Journal of Nursing Management, 17(10): 1340–1345.

Ai Y, Wu R, Li Y, 2021, Effects of Curvilinear Supine Positioning on Pressure Injury Incidence and Interface Pressure in Surgical Patients. Journal of Nurses Training, 36(1): 22–26.

Fu T, Ma Y, Yu M, et al., 2024, Impact of Curvilinear Supine Positioning Combined with Developmental Feedback Nursing Model on Patients in Emergency Intensive Care Units. Qilu Journal of Nursing, 30(23): 33–36.

Guo Y, Zhao K, Zhao T, 2019, The Effectiveness of Curvilinear Supine Position on the Incidence of Pressure Injuries and Interface Pressure Among Surgical Patients. Journal of Tissue Viability, 28(2): 81–86.

Chen J, Liu H, Hu R, 2023, Meta-Analysis of Curvilinear Supine Positioning for Prevention of Pressure Injuries. Evidence-Based Nursing, 9(15): 2661–2669.

Gao X, Guo L, He L, et al., 2023, Expert Consensus on Prevention of Intraoperative Acquired Pressure Injuries. Journal of Nursing Science, 38(1): 44–47.

Mondragon N, Zito P, 2024, Pressure Injury. StatPearls, Treasure Island (FL): StatPearls Publishing.

Wang Z, Zhang W, 2022, Research Advances on Risk Factors and Assessment of Intraoperative Acquired Pressure Injuries in Children. Chinese Journal of Nursing Management, 22(11): 1727–1731.

Helden T, Neck J, Versnel S, et al., 2023, Clinical Applicability of Sensor Technology with Body Position Detection to Combat Pressure Ulcers in Bedridden Patients. Medical Engineering and Physics, 124: 104096.

Bauer K, Rock K, Nazzal M, et al., 2016, Pressure Ulcers in the United States’ Inpatient Population From 2008 to 2012: A Retrospective Nationwide Study. Ostomy Wound Management, 62(11): 30–38.

Song H, Wang Y, Zheng C, 2024, Development of an Evidence-Based Nursing Practice Protocol for Prevention of Pressure Injuries in Surgical Patients. Chinese General Practice, 22(3): 517–521.

Zhang G, 2022, Risk Factors and Preventive Nursing Care for Intraoperative Pressure Injuries in Surgical Patients. International Journal of Nursing, 41(6): 986–990.

Yoshimura M, Kohno M, Okamoto Y, et al., 2024, Reduction of Intraoperatively Acquired Pressure Injuries in the Park-Bench Position Using Soft Silicone Multilayer Foam Dressings. International Wound Journal, 21(2): e14407.

Liu F, Wang S, Ji W, 2022, Analysis of Influencing Factors of Intraoperative Acquired Pressure Injuries in Surgical Patients. Qilu Journal of Nursing, 28(22): 78–81.

Teng S, Chen S, Peng L, 2022, Risk Factors for Pressure Injuries in Infants and Young Children Undergoing Surgery. Chinese Journal of Modern Nursing, 28(23): 3189–3192.

Wu S, 2019, Effect of Curvilinear Supine Nursing Model on Prevention of Postoperative Pressure Ulcers and Patient Comfort in Orthopedic Patients. Chinese Journal of Practical Nursing, 35(1): 37–41.