8 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 8
Can positioning
devices that protect
muscles and nerves
from injury damage
patients' skin? About
5% of patients suf-
fered skin tears while
in the prone position
on a spine table and
while in the lateral
position during hip
procedures, nurses at
Houston Methodist Sugar Land (Texas) Hospital noticed while
doing chart reviews in 2013.
Nurses and wound care specialists got together to figure out a
way to reduce the skin tears. Their solution: Place a multi-lay-
ered silicone foam pressure dressing on patients' points of con-
tact with the positioners. And that did the trick. OR staff apply the
dressings once patients are asleep and remove them before
patients emerge. The hospital implemented the practice in
September 2013 and incidents of skin tears have been reduced to
0.06% through May 2017.
"Skin tears are always a concern when positioning in the OR,"
says Shelly Boyne, BSN, RN, CNOR, CST, a registered nurse III at
Sugar Land Hospital. "Some patients have very fragile skin, but
we found that when specific positioners were used, an increase in
skin tears occurred in locations where the positioners made con-
Positioning Devices Can
Be Rough on Patients' Skin
• CONTACT DRILL Skin that contacts positioning devices during certain sur-
geries is vulnerable to shearing.
