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Heel calf capillary-support pressure in lithotomy positions
Rebecca A Roeder1, Leslie A Geddes, Neal Corson
1Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Ind., USA.
AORN Journal
|May 7, 2005
Summary
Pressure ulcer risk in lithotomy positions is linked to leg elevation. Higher heel elevation increases capillary pressure, particularly for the heel, suggesting a need for careful positioning to prevent pressure ulcers.
Area of Science:
- Biomedical Engineering
- Clinical Medicine
- Patient Safety
Background:
- Pressure ulcers are a significant concern in surgical patients, especially those in lithotomy positions.
- Understanding the physiological factors contributing to pressure ulcer development is crucial for prevention strategies.
Purpose of the Study:
- To investigate the relationship between patient positioning in lithotomy and the development of pressure ulcers.
- To quantify capillary pressure changes at different leg elevations using an innovative measuring device.
Main Methods:
- A three-part analysis was conducted involving pressure ulcer risk assessment.
- Capillary pressure was measured using an innovative device in participants in standard and high lithotomy positions.
- Ankle blood pressure and capillary-support pressures in the calf and heel were recorded at varying heights.
Main Results:
- Ankle systolic and diastolic pressures decreased by approximately 20 mmHg per foot of elevation.
- Calf capillary-support pressure was significantly lower than heel capillary-support pressure in the standard lithotomy position.
- Increased heel height in the high lithotomy position correlated with increased heel capillary-support pressure.
Conclusions:
- Patient positioning in lithotomy significantly impacts capillary pressure and thus, pressure ulcer risk.
- The heel is more susceptible to pressure-related injury than the calf in lithotomy positions.
- Elevating the heel in lithotomy positions increases capillary-support pressure, potentially exacerbating pressure ulcer risk.