Subsequent to two separate GYN procedures that required Lithotomy positioning, we have had two separate patient injuries. They have been discovered post-op in the MD offices to have blistered areas on their buttocks approximately 3-4cm x 8-10cm on their buttock areas near the coccyx area. This is well away from the bovie ground pad. On both of these patients, gel pad , pressure-relief pads were used and documented. They both used ESU units with REM monitoring. Monopolar ESU was used with normal settings. The patients were bot prepped with betadine scrub and paints. The area was described by the surgeons as looking like a burn, reddened with small blisters. Doesn't appear to be an ESU burn, we are thinking perhaps pressure-related and/or a chemical burn from the prep solution remaining in contact with the skin for the duration of the procedure. (The "burn" would appear to be in the area where solution would pool with a patient in the lithotomy position. These patients were both treated w/ silvadene cream and recovered uneventfully.
Anyone ever experience this and any suggestions???????????What am I missing here?
Dec 19, '06
We have not had that type of a problem. It does sound like the problem is from the pool of solutions under the patient. Use towels tucked around the patient's bottom and on the sides to absorb any run off from the prep. Carefully remove them prior to draping.