P5. Face Tissue Pressure in Prone Positioning: A Comparison of Three Face Pillows While in the Prone Position for Spinal Surgery

Grisell, Margaret; Place, Howard M.

doi:10.1016/j.spinee.2007.07.209

Cited by 14 publications

(37 citation statements)

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“…Many position-related complications have been reported for the prone position, with facial pressure ulcer being its well-known complication, which is most likely to occur at the forehead and chin. 14,15 These sites have little muscle mass; thus, within the time period required for laminoplasty, pressure ulcers may likely form because of the high interface pressure and local blood supply shortage. In this study, the incidence of pressure ulcers was 11.39%, while in the lateral position, the incidence of pressure ulcers was only 2.18% in the lateral positions.…”

Section: Discussionmentioning

confidence: 99%

<p>Lateral Position versus Prone Position for Cervical Laminoplasty: A Retrospective Comparative Study</p>

Du¹,

Gao²,

Gao³

et al. 2020

TCRM

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Purpose: To examine the safety of lateral decubitus positions for cervical laminoplasty. Patients and Methods: A retrospective comparative study was conducted on the safety between the lateral and prone positions in cervical laminoplasty. After screening, 466 patients who underwent cervical laminoplasty at a single medical center were enrolled and categorized into the lateral (n=229) and prone (n=237) groups. Data on positioning time, surgical time, blood loss, complication rates, and surgical outcomes were collected and compared between the two groups. The patients were further divided into underweight, normal weight, overweight, and obesity subgroups according to their body mass index, and the collected data were compared between the lateral and prone groups. Results: The lateral group had a lower incidence of facial pressure ulcers (2.18%) than the prone group (11.39%). However, positioning time, surgical time, blood loss, and surgical outcomes were not significantly different between the two groups. In the subgroup analysis, no significant difference in positioning time, operative time, and blood loss was observed in the underweight, normal weight, and overweight patients between the two groups, but in the obesity subgroup, the lateral group had a significantly shorter positioning time (15.23±6.44 vs 21.63±9.43 min, P=0.045) and operative time (140.16±40.48 vs 178.62±51.82 min, P=0.037) and lesser blood loss (285.31±171.75 vs 430.46±189.84 mL, P=0.044) than the prone group. Conclusion: The lateral position is as safe as the prone position for cervical laminoplasty, but it has advantages over the prone position for patients with obesity.

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Section: Discussionmentioning

confidence: 99%

<p>Lateral Position versus Prone Position for Cervical Laminoplasty: A Retrospective Comparative Study</p>

Du¹,

Gao²,

Gao³

et al. 2020

TCRM

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“…All selected studies used quantitative methodology. Half (five) of the studies were from the US [12][13][14][15][16] and three from Europe [17][18][19] . Seven studies used prospective research approaches 13, 14, 16-18, 19,20 and eight studies consecutive sampling methods 9,[12][13][14][15][18][19][20] .…”

Section: Discussion Of Findingsmentioning

confidence: 99%

“…Half (five) of the studies were from the US [12][13][14][15][16] and three from Europe [17][18][19] . Seven studies used prospective research approaches 13, 14, 16-18, 19,20 and eight studies consecutive sampling methods 9,[12][13][14][15][18][19][20] . The majority (seven out of ten) of the included articles were conducted at a single hospital site 9,12,14,15,[17][18][19] .…”

Section: Discussion Of Findingsmentioning

confidence: 99%

“…Three included articles examined support surfaces 12,14,17 , and two of these used randomised controlled trial approaches 14,17 . In this review, operating table mattresses (i.e.…”

Section: Discussion Of Findingsmentioning

confidence: 99%

“…arm board, facial pillow, pillow, gel pad or heel pad) were used for different surgical positions. However, the effectiveness of these support surfaces and positioning aids varied [12][13][14][17][18][19][20] . In the literature, using higher specification foam mattress and/or overlays in the operating room rather than the standard hospital foam mattress to prevent or reduce the incidence of intraoperative PI is recommended 8,21,22 .…”

Section: Discussion Of Findingsmentioning

confidence: 99%

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Pressure injury prevention in the perioperative setting: An integrative review

Wang¹,

Walker²,

Gillespie³

2018

Journal of Perioperative Nursing

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Background: Pressure injury (PI) has a significant impact on patients and their families, and is costly to health care institutions. Perioperative PI remains problematic, although little is reported about current perioperative pressure injury prevention (PIP) strategies. Aim: To identify the key perioperative PIP strategies, following a systematic review of published research, to describe existing gaps in the literature, and to inform the development of subsequent observational study. Design: An integrative literature review method developed by Whittemore and Knafl 1 was used. Method: Research inclusion and exclusion criteria were identified a priori. Six data bases were searched and search terms included pressure ulcer/sore prevention, perioperative, operating room. Two review authors evaluated the quality of the studies using a validated tool, and a third author arbitrated when there was a discrepancy. Agreement between the two rates was measured using an intraclass correlation coefficient (ICC). Findings: Based on the inclusion and exclusion criteria, 270 papers were screened and ten quantitative studies were included. Quality scores ranged from 29 per cent to 89 per cent, resulting in an ICC of 0.955 (95 per cent confidence interval, 0.821 to 0.989, p < 0.0001). Five key PIP strategies were identified, including skin inspection, support surfaces and positioning aids, thermoregulation, medical devices and/or equipment, and interprofessional communication. Conclusions: This review confirmed the scarcity of current evidence of perioperative PIP practice and identified five key perioperative PIP strategies. Most of the reviewed studies focused on one main PIP strategy, and no direct observational studies have been undertaken in relation to perioperative PIP.

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Applying a human factors approach to proning pillows in the ICU: Opportunities for redesign

Desselle,

McLeod,

Byram

et al. 2023

Hum Ftrs & Erg Mfg Svc

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Proning, or turning a patient face down, is a technique used to manage patients with acute respiratory distress in intensive care units (ICUs). Research suggests that the type of pillow used in proning may have a significant impact on patient outcomes and increase the risk of disfiguring pressure injuries to the face. However, there is little evidence surrounding the usability of these pillows in the ICU. The aim of this study was to identify redesign opportunities by understanding how the tools, tasks, people, environment, and organization all interact during proning in the ICU. Thirty‐six ICU clinicians from two Australian public metropolitan hospitals completed an online questionnaire regarding their opinions and experiences with proned patients and the prevention of pressure injuries. Seven ICU clinicians then completed journey mapping activities to document the key workflows, critical incidents, considerations, and personnel involved in managing proned patients in the ICU. Several barriers and facilitators to pressure injury prevention were identified, including interactions between the various tools (e.g., proning pillows with one opening limits the management of several medical devices), the tasks (e.g., high frequency of repositioning), the people (e.g., clinical inexperience, patient features), the environment (e.g., limited availability of tools), and the organization (e.g., limited number of staff to support tasks). This holistic approach revealed several opportunities for the redesign of proning pillows and associated systems. Key takeaways include the limitations of a one‐size‐fits‐all approach to proning in the ICU context, and the need for flexibility and customization to improve proning pillows, associated medical devices, prophylactic dressings, aids, and processes.

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P5. Face Tissue Pressure in Prone Positioning: A Comparison of Three Face Pillows While in the Prone Position for Spinal Surgery

Cited by 14 publications

References 0 publications

<p>Lateral Position versus Prone Position for Cervical Laminoplasty: A Retrospective Comparative Study</p>

<p>Lateral Position versus Prone Position for Cervical Laminoplasty: A Retrospective Comparative Study</p>

Pressure injury prevention in the perioperative setting: An integrative review

Applying a human factors approach to proning pillows in the ICU: Opportunities for redesign

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