When a patient is supine on a fracture table for the anterior
approach, make sure the lateralized perineal post is well padded to
minimize risk of pudendal nerve compression. Also ensure the feet
are in padded boot holders. The hip distractor system that attaches
to the foot of the table must ease the surgeon's entry into the joint
and im-prove visualization of the central compartment.
Total team effort
Always focus on protecting the areas of a patient's skin that come in
contact with positioners and table attachments. During longer surger-
ies such as joint replacements, patients are also at risk of developing
vascular injury, which could involve the compression of a vein and,
ultimately, development of a blood clot.
"The decision of how to best position the patient must be based on
the surgeon establishing what he needs to have full exposure of the
joint," says Ms. Rose. "But nurses must also make sure the patient is
positioned safely, that they're properly supported and that there is lit-
tle shearing or friction between their skin and the surface they're on."
OSM
A U G U S T 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 8 5
tact with skin.
"Now it's standard practice in our ORs to put the multi-layered
silicone dressings on any area of the patient that will make con-
tact with positioners," says Ms. Boyne. "There's rarely a perfect
solution to any issue, but this has significantly reduced the occur-
rence of skin tears." — Mike Morsch