cal procedures of less than 1 hour.
Horizontal approach
I champion a "horizontal approach" to pressure management and
risk mitigation. By that, I mean we should address our surfaces and
pressure redistribution and relief devices in all settings where a
patient can be subject to unrelieved pressure. That includes pre-op
and post-op settings as well as the OR.
The most important surface, of course, is the OR table. The low-
hanging fruit here includes standardization of high specification OR
table pads. These pads, which absorb the patient's weight through
immersion and envelopment, and redistribute pressure in specific
areas commonly associated with perioperative pressure injuries, are
designed to reduce pressure by distributing load away from high-pres-
sure points.
So-called dynamic support surfaces can compensate for an inabili-
ty to reposition a patient during a longer case. You're probably famil-
iar with such non-dynamic overlays and positioners as water, foam
and gel. Prophylactic dressings such as 5-layer silicone foam dress-
ings are an emerging prevention approach — researchers are cur-
rently evaluating them for their effectiveness in high-risk patients
and positions. These dressings have a silicone backing that lets you
assess the skin under the dressing and reseal.
What procedures do you perform at your facility, and what patient
positions are used most frequently? The answers will determine what
types of support surfaces and other preventative measures you should
research and use.
AORN reports the overwhelmingly most common site for a pres-
sure injury is the sacrum, followed by the heels, chin, sternum and
trochanters. Sacral and heel injuries are associated with the supine
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