Patient positioning is vital in preventing tissue damage and pressure ulcers in the operating room. Proper patient positioning depends on the type and length of the procedure, anesthesia access to the patient, and the Pressure Relieving and Redistribution Devices being used.
Pressure-relieving and redistribution devices support and reduce the risk of developing peri-operative pressure injuries under bony prominences during surgeries.
In this article, you will learn:
Pressure Ulcers are identified as localized damage to the skin or underlying soft tissue, usually occurring over a bony prominence due to pressure or pressure combined with shear or can be related to the use of medical or other devices.
Alternate names for pressure injuries are decubitus ulcer, bed sore, and pressure sore.
The intensity of the pressure, as well as the duration of the pressure, contribute to the injury.
Pressure relieving devices, like mattresses and gel positioners, improve the body contact area through envelopment/contouring and/or immersion. However, these devices do not provide active pressure reduction and possibly limit the redistribution the underlying surgical table pad offers. Pressure redistribution devices and surfaces use alternating air pressure to allow blood to flow (perfuse) back into the tissues. They can be used with redistribution devices like bean bags and gel pads.
Once patients are placed on these surfaces, they reactively or passively redistribute body weight. They work in response to the patient's weight and can fully compress under the patient. They may be powered or unpowered.
Immersive surfaces like these work at overall pressure reduction on certain patient surfaces, but even lower overall pressure over time can and does result in pressure injuries. This may not prevent a pressure injury on more lengthy procedures.
They can come in sets or individual pads that attach to the surgical table or portable systems that go on multiple surfaces and environments.
Browse STERIS Pressure Management Systems
Used in supplement with tabletop pads for promotion of proper patient positioning. They can come in various shapes to support and protect different areas of the body like heels, elbows, sacral area, etc.
Browse STERIS Gel Positioners
These cushions are filled with air and can be adjusted to suit the individual's needs.
These cushions are made of foam, help to distribute pressure over a larger surface area, and can be disposable.
Browse STERIS Foam Positioners
These devices are worn on the heels to reduce pressure and prevent pressure injuries.
Browse STERIS Heel Protectors
These devices are worn on the elbows to reduce pressure and prevent pressure injuries.
Browse STERIS Arm Protectors
These devices are active support surfaces, made of air cells that mechanically alternate the pressure beneath the body to reduce the duration of the pressure on the body by alternately inflating and deflating to change the contact area and, In other words, redistributing the pressure.
Redistribution devices are optimal for high-risk patients; can be used in all phases of perioperative care in pre-op, the operating room, and postop in PACU; operate with cyclical inflation and deflation; and require power.
These mattresses use air cells that alternate in inflation and deflation to help redistribute pressure.
These beds use tiny silicone beads suspended in air, creating a fluid-like environment that helps redistribute pressure.
Pressure relieving devices can help reduce pain and discomfort associated with pressure injuries, improving the patient's comfort.
By reducing the risk of pressure injuries, patients are more likely to maintain their independence and have a better quality of life.
Pressure injuries can lead to increased healthcare costs due to more extended hospital stays, additional treatments, and the need for specialized wound care. By preventing pressure injuries, pressure relieving devices can reduce healthcare costs.
Pressure injuries can lead to severe complications such as infections, sepsis, and death. Pressure-relieving devices can reduce the risk of these complications by preventing pressure injuries.
Pressure redistribution devices help to redistribute pressure over a larger surface area, reducing the pressure in any spot. This can help to prevent pressure injuries from developing in the first place.
For patients with pressure injuries, pressure redistribution can help promote healing by reducing the amount of pressure on the affected area.
Pressure injuries can lead to the need for additional treatments, such as wound care or surgical interventions. By preventing pressure injuries, pressure redistribution devices can reduce the need for these other treatments.
Lena Fogle BSN, RN, CNOR
Senior Director Global Clinical Solutions, STERIS Healthcare
Lena is a seasoned healthcare leader with extensive experience leading complex perioperative environments as well as new program development, continuous process improvement, clinical outcomes, operational excellence, and stakeholder experience.