Decreasing Intraoperative Skin Damage in Prone Position Surgeries
Condition: Pressure Injury
MeSH terms: Crush Injuries
Intervention: Mepilex Border Flex® (MBF) dressing
Intervention description: A new dressing technology (Mepilex Border Flex® (MBF)) provides increased conformability of the dressing to the skin with the ability of the dressing to move in all directions (e.g., 360-degree flexibility) with even slight body movements. Limited data exists on use of silicone foam dressings with all direction flexibility during prone surgical procedures.
Phase: Phase 4
Study type: Interventional
Primary purpose: Prevention
Allocation: Non-Randomized
Intervention model: Sequential Assignment
Intervention model description: In months 1-3 Pre-Intervention participants will have 6 skin assessments at face (chin, cheeks, forehead), chest, and iliac crest: preoperative, Post Anesthesia Recovery Unit, transfer to floor, and post-operative days 1, 3 and 5.
In months 4-6 Intervention participants will have the same skin assessments at the same times and will have the dressings placed pre-operatively and removed following surgery.
Masking: None (Open Label)
Enrollment: 107.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      Preventing Pressure Injuries among patients undergoing spinal or orthopedic surgery in the
      prone position is challenging because of position required for surgical access and limited
      availability of pressure reduction surfaces for prone position operating tables. A new
      dressing technology (Mepilex Border Flex® (MBF) provides increased conformability of the
      dressing to the skin with the ability of the dressing to move in all directions (e.g.,
      360-degree flexibility) with even slight body movements. Limited data exists on use of
      silicone foam dressings with all direction flexibility during prone surgical procedures.

      The investigators will partents scheduled for surgery in the prone position at UCLA Santa
      Monica Medical Center and propose to examine use of the MBF dressings on the chest, iliac
      crest, and face (chin, cheeks, forehead) of patients undergoing this type of surgery using a
      prospective, non-randomized pre/post intervention clinical trial design.

      Three outcome measures will be compared between patients undergoing prone surgery with
      standard care (no dressings, pressure reduction positioning on the operating table) and those
      with standard care and use of MBF dressings placed on the chest, iliac crest and face: (1)
      incidence of erythema and pressure injuries on face, chest and iliac crest determined by
      visual skin assessment between the two groups, (2) incidence of moisture associated skin
      damage (MASD) and friction abrasions on face, chest and iliac crest determined by visual skin
      assessment between the two groups, and (3) SEM measures indicative of pressure injury damage
      on face, chest, iliac crest between the two groups.

      The study will also include a 6-month retrospective medical record review of patients who
      underwent prone surgeries from February 1, 2018 through July 31, 2018 to determine a
      historical pressure injury facility incident rate. The year 2018 was chosen to avoid changes
      associated with the COVID-19 pandemic.
    

Eligibility criteria:

        Inclusion Criteria:

          -  A participant must 18 years or older and is scheduled for surgery in the prone
             position to be conducted at UCLA Santa Monica Medical Center.

        Exclusion Criteria:

          -  Patients who are not scheduled for surgery in the prone position. Patients with known
             allergy to the components of the Mepilex Border Flex (MBF) dressing which consists of
             silicone, polyurethane, polyacrylate, viscose, polyester and polyolefin.