Evaluating the association between preoperative cutaneous conditions and incidence of postoperative skin disorders in patients undergoing lateral decubitus surgery under general anesthesia: A prospective cohort study

Attributes of the study participants
A total of 106 patients were scheduled to undergo surgery during the study period. Patients who underwent emergency surgery (n = 4) and those in whom the surgery duration exceeded 4 h (n = 16) were excluded. No patients were lost to follow-up (Fig. 1). Patient characteristics and surgical and anesthetic factors are shown in Tables 1 and 2. Patient characteristics showed no significant differences in terms of age, sex, height, weight, BMI, and preoperative total protein, albumin, or hemoglobin levels between the postoperative skin disorder group and the normal group.
Comparison of surgical and anesthetic factors, including duration of surgery, duration of anesthesia, amount of bleeding, total fluid volume, and urine volume, also showed no significant differences between the two groups.

Skin Factors
Significant differences were observed in terms of skin moisture and TEWL between the two groups, with the postoperative skin disorder group showing higher skin moisture and TEWL (p<.01). This indicated that these skin factors are potentially important in the development of postoperative skin disorders (Table 3).

Multiple Regression Analysis of Postoperative Skin Disorders
Multiple regression analysis identified TEWL as a significant predictor of postoperative skin disorders (R2 = 0.545, adjusted R2 = 0.545) (B= -0.094, p < .01) (Table 4).

Receiver operating characteristic curve analysis of TEWL
Area under the receiver operating characteristic curve was 0.691 and the Youden index was 0.403. Sensitivity and specificity were 0.500 and 0.903, respectively. The area under the receiver operating characteristic curve was considered positive if postoperative skin damage was observed. Based on this, the cut-off value for TEWL was set at 19.5 g/m2/h.