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Elective Surgery is Essential - August 2020 - 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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S pine surgery patients placed in the prone position can develop pressure injuries on areas of their bodies with- out much natural protection. Fortunately, there are plenty of prod- ucts and practices that can help keep their skin intact during complex cases that typically last longer than two hours. Efforts to prevent pressure injuries begin with pre-op assessments of the patient's skin integrity. Everyone's body habitus is different, however, so examine patients for potential trouble spots in pre- op. Also make sure they don't have some kind of chest deformity, a prominent set of ribs or have had a mastectomy traits that can increase the risk of pressure injures. Pad these areas as appropriate. In general, focus on protecting a patient's face, chest, chin and ribs. When assessing patients in pre-op, use the Scott or Munro trigger scales, which help to predict pres- sure injuries in surgical patients. In addition to these results, the biggest risk factor for pressure injury is the duration of the surgery. Any procedure lasting longer than 2.5 hours increases the likelihood of skin breakdown. Of course, patients with ASA scores of 3s and 4s have a higher risk than those with 1s or 2s — and there's a huge jump in risk between scores of 2 and 3. Operations are often longer for patients with higher ASA scores due to the need for additional time to manage their underlying diseases. In addition, patients who have more comorbid disease often have surgical conditions in later stages requiring more 5 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 2 0 Joyce Black, PhD, RN, CWCN, FAAN | Omaha, Neb. Prevent Spine Surgery Pressure Injuries Tables, padding, pressure sensors and skin assessments protect prone patients during lengthy procedures. PRONE TO INJURY Patients who are face-down for spine procedures are at risk for chin ulcers and other surgical-acquired pressure injuries. Joyce Black, PhD, RN, CWCN, FAAN

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