in the handoff, along
with concerns such as
the patient's position,
the length of surgery
and any devices that
might contribute to
injuries.
Monitoring (and
documentation)
should continue
during the surgery itself, with staff
checking for temperature, edema, redness and change
in skin consistency. Post-op, ongoing skin assessment is just as key.
Absence of skin damage immediately post-op doesn't mean the patient
is out of the woods. What we communicate in the handoff can set the
stage for an aggressive care plan post-op whether the patient goes to a
post-op bed or home. Family members can play an important role in
assessing for unusual pain or skin changes that they should report to
the physician and in follow-up clinic visits.
The duration of a surgery is a factor in the development of pressure
injuries — the longer the procedure, the more likely they are to devel-
op because of the progressive prolongation of pressure on the skin. If
it's possible to reposition the patient during a lengthier surgery, staff
should do so.
As an outpatient facility, you might not think your procedures are
lengthy enough to result in pressure injuries; indeed, the Scott
Triggers tool uses 3 hours as the standard for high risk. But sub-epi-
dermal moisture (SEM) scanners, which measure SEM values and
can detect pressure injuries long before visual signs are present, have
presented emerging evidence that tissue damage may occur in surgi-
4 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 1 9
