In the case of a 325-pound patient scheduled for lengthy surgery, which factor may also produce pressure injuries?

The choice of a self-retaining retractor post clamped to the OR bed rail highlights a specific mechanical factor that can lead to pressure injuries in a patient who is heavier or has a higher body mass index. These retractors, although essential for maintaining a surgical field, can create points of concentrated pressure on the skin, especially when used for extended periods during lengthy surgeries. When a retractor is clamped to the bed rail, it can dig into the patient's body and restrict blood flow, increasing the likelihood of ischemia and subsequent pressure ulcers.

In heavier patients, the distribution of weight can exacerbate the pressure exerted on certain body parts, making the careful placement of surgical equipment even more critical. Since the retractor serves a dual purpose of keeping tissues out of the way while also being a potential source of pressure, it represents a tangible risk factor in the operating room environment for developing pressure injuries.

The other options present scenarios that may indeed relate to the risk of pressure injuries, but they do not highlight as direct or significant a risk as the clamping of the retractor. For example, while excessive movement can lead to injuries in some cases, a patient under anesthesia may not experience significant movement. Options involving the use of standard OR beds or prolonged