Padding devices to prevent skin breakdown

[Tucwebb]

As a new RN to the OR, we are doing an evidenced based practice project regarding the best types of padding to prevent skin breakdown in surgical patients.

1) What types of pressure reducing aids/padding materials are being utilized in your OR to prevent skin breakdown?

2) In your professional opinion, what is the best material for use in protecting and avoiding skin breakdown of the intraoperative patient?

3) In regard to your answer to #2 above, what is the rationale for your answer?

Thank you all for your help. We look forward to reading your responses.

[sweet31eve]

We are researching this as well. After looking further into it, we have opted to give ConMed AirSoft positioning devices a try. I attended the inservice that Conmed hosted at AORN Congress in New Orleans and contacted our local rep who brought in padding to for trial use. It is lightweight, easy to clean and does the job. We also have foam in our OR, but being disposable it gets pricey. We also use gel...heavy!!! So far ConMed is my favorite. It is an expensive intial investment, but if you compare it to the long run and what it would cost for disposable padding it is cheaper. Personally, I hope we go to completely AirSoft and get rid of the foam and the gel pads. By the way, Conmed has an excellent booklet (with CEU credits) about prevention of skin breakdown that the sales rep can bring in for your staff.

Geez, ConMed should give me $$ for this sales pitch! :rotfl:

[Tucwebb]

Anyone else?

[jwk]

Foam works fine for most things. And most of the time, you're padding more to prevent nerve injury than you are to prevent skin breakdown.

[Jane1988]

I agree with jwk in that when padding you are protecting from nerve damage versus skin damage. The most susceptible nerves are the ulnar and the sciatic nerves.

The ulnar can be damaged when your pt lies supine with arms postioned on the bed or on the armboards. This type of nerve damage is the most frequent c/o to anesthesia resulting in legal actions. The sciatic nerve may receive compression in Fowler's position.

In our two-room OR, we primairly use foam (looks like eggcrate material), pillows, gel-pads, bean-bag device, and more pillows. We also use a helmet system for pts in Fowler's, but this may be for positioning and not for skin protective purposes.

Any ideas for shoulder arthroscopy postitioning? This part of the surgery is a nightmare.

[mcmike55]

A while back, we changed all of our OR table mattresses, to that memory foam type stuff. Amsco/Steris is our company. We did that pressure point CEU books too,,,good stuff, nice especially for our new nurses.

We also use bean bags for lateral positions, one of ours has gel on one side as well.

I am a big fan of those gel pads. Different sizes and densities, yea they are a bit heavy, especiallly for the full table models, which we use sometimes in addition to the special mattresses.

We are pretty lucky, in the past year or so, I don't think any case we have had lasted more than 3 or 4 hours.

We are big on using TED Hose and SCD's as well, on the legs.

Our shoulder table extention is also from Steris/Amsco. We use those memory foam pads, and augment with gel pads as needed when up in semi-fowlers.

Mike

[Marie_LPN, RN, LPN, RN]

1) What types of pressure reducing aids/padding materials are being utilized in your OR to prevent skin breakdown?

Action gel pads, pillows, towels (wrapped in a pillowcase), blankets, and eggcrate foam as a one-time use padding.

2) In your professional opinion, what is the best material for use in protecting and avoiding skin breakdown of the intraoperative patient?

Depends on the area needing protected and what it's being protected from.

3) In regard to your answer to #2 above, what is the rationale for your answer?

It all depends on how the part. That's when we determine what we use and when.

[tong2moca]

hello! i know that the last post in this topic is agesago.. but i would like to ask everybody.. what is the proper way of using gel pads for the patients? the reason im asking is that, in the hospital where i previously worked, we used to put the gel pads under the linen cover.. but now, im working in a different setting where they put gel pads directly to patient's skin.. i know its more proper as we can obtain the purpose of gel pads for OR patients.. but i just have a question to raise.. in ORs, it is usually cold.. and these gel pads get cold as well.. and when the patient comes in, he/she is already feeling very cold due to anxiety and fear of unknown.. and these cold gel pads add up to it..