My question to you is, does your facility have a policy in place? if not, maybe it should. Ask the educator. I have been taught that for men you should always tape the foley upwards and downwards for women. I'm not so sure I would worry about a pressure sore unless the surgery was going to be a long one. Also what area of the body is being operated on, and what is the rational behind the tube being under or over other than being in the way of the surg. Things that make you say hummmmmmm.