Exploring the New Standards in Patient Positioning
For over 50 years, the Association of Perioperative Registered Nurses has been recognized as the world leader in the development of standardized OR techniques. Their recommendations are roundly seen to represent what is believed to be the optimal level of practice, policies and procedures.
This year, AORN released their 2017 Guidelines for Perioperative Practice, offering evidence based guidelines for all perioperative and invasive procedures from Aseptic Practice to Patient Care and Sterilization, with many more topics in between.
Use of Gel in Pressure Injury Prevention
It is estimated that surgical patients account for 20-30% of all pressure injuries, an extremely high percentage. If the skin has broken down, the patient is immediately at higher risk of developing infection. In some cases patients have even been known to die from pressure ulcers. It is therefore of paramount importance that the correct steps are taken to eliminate their development.
The use of support surfaces containing materials such as gel and foam in the positioning of patients has long been advised; however the most effective pressure distributing surface remains somewhat inconclusive. At David Scott Company we have long been an advocate of the use of gel based products in the support of perioperative patients, and while the recent findings published in the AORN guidelines conclude that a multidisciplinary team should determine what support surfaces are used, gel compares extremely favorably against other support surfaces.
“The use of gel during procedures lasting 90 minutes or longer decreases the incidence of pressure injury by 0.51% resulting in an overall cost savings of $38 per patient.” Pham et al.
In a study conducted by King & Bridges, they found that versus an OR bed mattress and a polyurethane convoluted foam overlay, a gel overlay proved significantly better in the prevention skin breakdown and pressure sore development.
The researchers found that in the supine and lateral positions respectively, “participants sacral and trochanter pressures were significantly higher on the OR bed mattress with the foam overlay than on the OR mattress with the Gel Overlay”.
This matched up favorably with the findings of Hoshowsky and Schramm who found that “foam-and-gel mattresses and viscoelastic gel overlays were significantly more effective than foam mattresses in preventing skin changes and pressure injury, but the gel overlay was the most effective surface for preventing pressure injury.”
While Wu et al concluded that “the average and peak pressures measured at the points padded with the gel were significantly lower than at the points padded with high-density foam.”
View our full line of Blue Diamond Gel Pads & Positioners