Risk factors for ala nasi pressure sores after general anesthesia with nasotracheal intubation

PURPOSE: To prospectively investigate the risk factors that associate to ala nasi pressure sores after general anesthesia with nasotracheal intubation. MATERIAL AND METHOD: All Patients underwent oral and maxillofacial surgeries during May 2018 to December 2018 were enrolled in this prospective study. Alae nasi were evaluated after finishing of the operation under general anesthesia with nasotracheal intubation for having pressure sore or not. The seven suspected risk factors were investigated for evaluation of the significant association with ala nasi pressure sores. Descriptive, univariate, and multivariate statistics were computed, and the P value was set at .05. RESULTS: One hundred and fifty-five patients were enrolled. The incident of ala nasi pressure sore after general anesthesia with nasotracheal intubation was 21.45% in duration of six months. Risk factors associated with ala nasi pressure sore with univariate analysis were long duration of surgery, and lack of hydrocolloid dressing. After multivariate analysis, the significant risk factors for ala nasi pressure sores after general anesthesia with nasotracheal intubation were long duration of surgery (OR 1.005, 95%CI 1.002 to 1.009, p = 0.004), and lack of hydrocolloid dressing (OR 9.934, 95%CI 3.347 to 29.489, p < 0.001). While the significant protective factor was higher body mass index (OR 0.864, 95% CI 0.749 to 0.997, p = 0.045). CONCLUSION: Long duration of surgery and lack of hydrocolloid dressing are significant risk factors for ala nasi pressure sores after general anesthesia with nasotracheal intubation. While high body mass index is significant protective factor. Shortening the duration of surgery and using of hydrocolloid dressing between ala nasi and the nasotracheal tube or catheters that inserted via nose, such as nasogastric tube, are strongly recommended.