Watch the video to learn more
A note on terminology: ‘pressure ulcer’, ‘pressure injury, ‘pressure sore’ or ‘bed sore’ are all commonly used terms. We use ‘pressure injury’ throughout this article to include all the above.
The need for a pre-operative skin assessment and risk assessment
Approximately 25% of patients may be high risk for pressure injuries. For this reason, it’s important for the pre-op nurse to do a skin assessment before surgery as well as a risk assessment on the Braden scale, and to communicate the results to the OR team so they can take preventative measures.
Every prevented pressure ulcer saves a patient from unnecessary pain, extended care and potentially fatal complications.
Length of surgery and patient position can increase pressure injury risk
The first and most important factor is the duration of the surgical procedure. Pressure may not be particularly intense at the beginning, but over time the patient’s body weight compresses the foam of the operating table surface and pressure will increase.
The patient position also matters. A procedure where the patient is prone is considered high risk as there are many potential pressure areas (face, sternum, hips, knees and front of feet).
BMI can affect a patient’s risk of pressure injury
A high or low BMI may increase risk. A high BMI because of increased weight pressure; a low BMI because of less natural padding around pressure areas.
A history of skin injuries may increase pressure injury risk
Always ask the patient about previous skin injuries and check for any existing pressure injuries. If an existing pressure injury is found, it’s important to get advice from a Wound, Ostomy and Continence Nurse (WOCN).
Summary
Quick checklist of criteria:
- Length of surgery (and position)
- BMI
- History of skin injuries
For more tips on the practical steps you can take to protect patients from pressure injuries in the OR, see our article on Practical steps for nurses.
