Device Related Pressure Ulcer Related to Prolonged Neuro Surgical Procedures

Our facility is a nationally renowned brain and spine center engaging in research and treatment of injuries and diseases of the spine, brain and cardiovascular system.  Our surgeons perform complex spine procedures and surgery requiring prolonged prone positioning of the patients.  It became evident that skin breakdown was occurring on patients forehead due to the application of cutaneous electrode sensor that measures brain wave activity during sedation, anesthesia and surgery. In response to increasing number of  incidents of skin breakdown to the forehead post spinal procedure, peri-operative and operating suites were visited to assess and identify causative factors for skin breakdown.

The observation was noted  and confirmed by staff that it has been a common practice prior to the cutaneous electrode sensor application,  that forehead was being cleansed with alcohol swab that in turn made the skin very dry.  The cutaneous electrode sensor has 3 velcro electrodes that pressed against the skin as the patient positioned prone for 6 to 12 hours.

The recommendation was made for the following trial study.  Discontinuation of the use of alcohol swab to cleanse the skin prior to the cutanous electrode sensor application, instead a barrier film is to be applied. After a month trial and 30 spine surgery cases, a 100% success of no skin breakdown was achieved.  It was also noted that the application of the barrier film did not affect reading.  It has become a standard of practice being implemented within the network.