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Decreasing Intraoperative Skin Damage in Prone-Position Surgeries
Barbara M Bates-Jensen1, Jessica Crocker, Vicky Nguyen
1At the University of California, Los Angeles (UCLA), Los Angeles, California, US, Barbara M. Bates-Jensen, PhD, RN, FAAN, is Professor of Nursing and Medicine, Los Angeles School of Nursing and David Geffen School of Medicine; Jessica Crocker, BA, is Project Director, Division of Geriatrics, David Geffen School of Medicine; and Vicky Nguyen, MSN, is Graduate Student, School of Nursing. Lauren Robertson, BS, is Senior Quality Control Analytical Associate, ImmunityBio, Los Angeles, California. Deborah Nourmand, MSN, RN, is Registered Nurse, UCLA Santa Monica Surgery Center, Santa Monica, CA. At the School of Nursing, UCLA, Emily Chirila, BSN, is Nursing Student; Mohamed Laayouni, MSN, is Nursing Student; Ofelia Offendel, MSN, is Student Nurse; Kelly Peng, BA, is Graduate Student Research Assistant; and Stephanie Anne Romero, MSN, is Graduate Student Researcher. Gerry Fulgentes, MSN, RN, CWOCN, PCCN, is Clinical Manager, Wounds, Ostomy, and Continence Services, UCLA Santa Monica Medical Center. Heather E. McCreath, PhD, is Adjunct Professor, Division of Geriatrics, David Geffen School of Medicine, UCLA.
Multidimensionally flexible silicone foam (MFSF) dressings applied before prone-position surgery reduced intraoperative acquired pressure injuries (IAPIs). Subepidermal moisture (SEM) measures detected more damage than visual assessments, aiding prevention.
Area of Science:
- Medical Research
- Surgical Innovation
- Patient Safety
Background:
- Intraoperative acquired pressure injuries (IAPIs) are a risk during prone-position surgery.
- Early detection and prevention strategies are crucial for patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of subepidermal moisture (SEM) measures in detecting and preventing IAPIs.
- To assess the effectiveness of multidimensionally flexible silicone foam (MFSF) dressings in reducing IAPIs during prone-position surgery.
Main Methods:
- A clinical trial involving historical control, preintervention, and intervention groups.
- Application of MFSF dressings to the face, chest, and iliac crests preoperatively.
- Monitoring of visual skin assessments and SEM measures from preoperatively up to 5 days postoperatively.
Main Results:
- Fewer intervention participants developed postoperative erythema and SEM-defined IAPIs compared to preintervention participants.
- MFSF dressings mitigated IAPI risk factors including surgery length, skin tone, and BMI.
- SEM measures identified more instances of damage than visual skin assessments.
Conclusions:
- Preoperative application of MFSF dressings significantly reduced IAPIs in patients undergoing prone-position surgery.
- SEM measures are a valuable tool for detecting subclinical pressure injury, surpassing visual assessment accuracy.
- MFSF dressings, guided by SEM monitoring, represent a promising approach to IAPI prevention.
