Maintaining normothermia-managing microclimate
It’s important to maintain normal body temperature and manage the microclimate because excessive perspiration, moisture or heat at the skin level can lead to moisture associated skin damage that may lead to skin breakdown and increase the risk of PIs.
Consider the following for normothermia and microclimate:16
- Assess appropriate use of warming blankets on top of or beneath the patient
- Keep skin dry
- Monitor for pooling of fluids
- Use dry sheets or drapes to help wick moisture away from skin
Perioperative pressure injury prevention does not end when surgery does. Skin changes can appear up to 72 hours after surgery, and cell death in the skin tissue could still happen up to a week later. An injury may start as a burnlike lesion, bruise or blister. If a patient has poor blood circulation, the skin may have a mottled, irregular pattern that could lead to a more serious skin injury.5
Immediately following surgery, the patient’s skin should be cleaned and dried, then assessed for any changes in skin temperature, skin integrity, skin color, skin texture and turgor, and moisture status. When the patient is transferred to the post anesthesia care unit, it’s important to report the patient’s PI risk factors to the team there—including pre-surgery risk factors and any new risk factors that developed during surgery.
Post-surgery steps for skin health5
- Clean and dry the patient’s skin
- Assess the skin
- Communicate results of pre-surgery risk factors and potential new risk factors
- Communicate results of risk and skin assessments performed before, during and after surgery
Pressure injury prevention protocols for before, during and after surgeries requires understanding common and individual risk factors. To promote skin health, there are many important steps to take based on evidence-based best practices, including skin assessments and communication between patient care units. You can help by working with the care team to choose the right products and make skin health a priority.