AORN JOURNAL
NOVEMBER 1992, VOL 56, NO 5
Letters to the Editor
One Solution .for Pressure Sores
I
feel it is necessary to comment on the excellent article, “Pressure ulcer development in the operating room: Nursing implications,” in the August issue of the Journal. It is an informative update on the factors that contribute to the development of pressure sores, and it reinforces the importance of the perioperative nurse’s role in preventing pressure sores in the surgical patient. The section on preopehtive assessment of skin integrity with documentation of skin appearance at the end of the procedure is excellent. Our institution, a teaching facility, opened a year ago. Approximately 20% of our surgical cases last eight to 15 hours. At first, staff members were not used to such complex, lengthy procedures, and they were concerned and frustrated by the increasing number of pressure sores patients developed. We used to use gel pads and foam positioning aids on all surgical procedures where appropriate. Because patients still developed pressure sores, we formed a task force to develop possible solutions to our problem. At the suggestion of the task force, we began using air-filled cushions. We used the cushions for two patients whose surgeries lasted 36 hours each. Both patients remained supine throughout the procedures, and neither developed pressure sores. We continue to use the cushions for procedures of six hours or more. One of the references in the article reports 832
study results that indicate a statistically significant difference between four support surfaces, one of which is the air-filled cushion; however, the cushion is not mentioned in the Journal article. I agree that more research is necessary to test the effectiveness of all pressure-reducing pads, including the cushion, but I also believe this cushion deserves to be mentioned. BARBARA BATEMAN, RN, BS CLINICAL EDUCATOR/ PERIOPERATIVE SERVICES UNIVERSITY OF SOUTHERN CALIFORNIA HOSPITAL Los ANGELES Aictho1.s’ response. We thank Ms Bateman for her comments and hope the article will encourage others to report their successful methods of preventing pressure ulcers in the surgical patient. SUSANM. SCOTT,RN, BSN, CETN ENTEROSTOMAL THERAPY NURSE VETERANS AFFAIRS MEDICAL CENTERS LITTLER O C K ~ O R TLITTLE H ROCK,ARK
PATRICIA A. MAYHEW, RN, PHD ASSOCIATE PROFESSOR FOR MEDICAL UNIVERSITY OF ARKANSAS SCIENCES, COLLEGE OF NURSING LITTLEROCK ELIZABETH ANNHARRIS,RN, MNSc FORMER DIRECTOR OF THE SURGICAL CLUSTER UNIVERSITY HOSPITAL LITTLEROCK.ARK
NOVEMBER 1992, VOL 56, NO 5
Letters to the Editor
One Solution .for Pressure Sores
I
feel it is necessary to comment on the excellent article, “Pressure ulcer development in the operating room: Nursing implications,” in the August issue of the Journal. It is an informative update on the factors that contribute to the development of pressure sores, and it reinforces the importance of the perioperative nurse’s role in preventing pressure sores in the surgical patient. The section on preopehtive assessment of skin integrity with documentation of skin appearance at the end of the procedure is excellent. Our institution, a teaching facility, opened a year ago. Approximately 20% of our surgical cases last eight to 15 hours. At first, staff members were not used to such complex, lengthy procedures, and they were concerned and frustrated by the increasing number of pressure sores patients developed. We used to use gel pads and foam positioning aids on all surgical procedures where appropriate. Because patients still developed pressure sores, we formed a task force to develop possible solutions to our problem. At the suggestion of the task force, we began using air-filled cushions. We used the cushions for two patients whose surgeries lasted 36 hours each. Both patients remained supine throughout the procedures, and neither developed pressure sores. We continue to use the cushions for procedures of six hours or more. One of the references in the article reports 832
study results that indicate a statistically significant difference between four support surfaces, one of which is the air-filled cushion; however, the cushion is not mentioned in the Journal article. I agree that more research is necessary to test the effectiveness of all pressure-reducing pads, including the cushion, but I also believe this cushion deserves to be mentioned. BARBARA BATEMAN, RN, BS CLINICAL EDUCATOR/ PERIOPERATIVE SERVICES UNIVERSITY OF SOUTHERN CALIFORNIA HOSPITAL Los ANGELES Aictho1.s’ response. We thank Ms Bateman for her comments and hope the article will encourage others to report their successful methods of preventing pressure ulcers in the surgical patient. SUSANM. SCOTT,RN, BSN, CETN ENTEROSTOMAL THERAPY NURSE VETERANS AFFAIRS MEDICAL CENTERS LITTLER O C K ~ O R TLITTLE H ROCK,ARK
PATRICIA A. MAYHEW, RN, PHD ASSOCIATE PROFESSOR FOR MEDICAL UNIVERSITY OF ARKANSAS SCIENCES, COLLEGE OF NURSING LITTLEROCK ELIZABETH ANNHARRIS,RN, MNSc FORMER DIRECTOR OF THE SURGICAL CLUSTER UNIVERSITY HOSPITAL LITTLEROCK.ARK
