Outpatient Surgery Magazine

No Guarantees - March 2017 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 41 of 138

2. Keep skin moisturized. Dry skin is more susceptible to pres- sure ulcers. Advise patients with dry skin to use a moisturizing cream in the leadup to surgery, and to shower only every other day — show- ering can dry skin out more — and to use a soft sponge for gentle cleansing in the shower in the weeks leading up to surgery, as vigor- ous scrubbing can make skin more vulnerable to breakdown, accord- ing to leading pressure ulcer researcher Courtney Lyder, ND, ScD(H), FAAN, a professor of nursing at UCLA. "While there's no clinical research on this, it's general knowledge in the field that having good moisture is one of the things that prevents skin breakdown," says Carlos Galeano-Rodriguez, MD, certified wound specialist physician with Vohra Post-Acute Physicians in Pittsburgh, Pa. 3. Turn patients in pre-op. If immobile patients are waiting long in pre-op, turn them at least every 2 hours by 30 degrees — alternat- ing onto their right side, back and left side. When moving from the back to the side, place a pillow behind them, tucked under the sacrum, and place another between the legs to keep the ankles from resting on top of each other and creating pressure. When a patient is on his back, avoid putting a pillow under the knees, as this can increase pressure on the heels. Instead, put a pillow under the calves, so that the heels are lifted. If patients are in such pain that it's not pos- sible to move them by 30 degrees, encourage them to engage in micro turns by subtly shifting their weight. Don't let patients drag them- selves in order to shift on their own, as dragging can lead to skin breakdown. 4 2 • 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 R C H 2 0 1 7

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