of strap-related skin
injuries. In addition,
surgeons might ask to
have the table's sur-
face tilted to the side
in order to increase
access to a surgical
site in the abdomen.
That shifts a signifi-
cant amount of body
weight onto pelvic
bones, which can
cause ulcerations in
areas you might not
expect.
Perform a complete
skin assessment on
every patient, even
those who aren't con-
sidered high-risk or
who are undergoing
relatively brief proce-
dures. There's been
some pushback
against that from OR
staff members, who
wonder why they should examine the entire body if the operation is
only occurring on the sinuses or eyes. All anesthetized patients are in
fact at risk — including the small, elderly woman who's scheduled for
cataract surgery. Her spine is likely quite prominent and needs to be
1 1 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
Before surgery
• operations planned for 3
hours or more
• age older than 62 years
• albumin less than 3.5 g/dl
• ASA score 3 or higher
• cardiopulmonary bypass
• operations requiring the
prone position
• diabetes
• trauma, orthopedic, vascu-
lar, transplant or bariatric
procedures
• body mass index below 19
or above 40
During surgery
• increased hypotensive
episodes
• low core body temperature
• use of vasopressors
After surgery
• reduced mobility on post-
op day 1
• use of vasopressors
SOURCE: Published in the
journal Wounds International
RED FLAGS
Pressure Ulcer Risk Factors
• SKIN IN THE GAME Limiting a patient's risk of injury during surgery protects your facility from litigation.
Pamela
Bevelhymer,
RN,
BSN
