[Prevention of decubitus ulcers in the operating room. Study of the support pressure in patients on the operating table and operating table anti-decubitus mattresses].
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Operating tables evolved in several stages. The most dynamic period was situated between 1860 and 1920: the surgeons of numerous countries were conscious of the necessity of specific tables for surgery. Introduction of anaesthesia in 1846 and asepsis in 1870 have strongly allowed this development.
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In order to facilitate intra-operative use of magnetic resonance imaging (MRI) in neurosurgery an MRI-compatible headholder was developed and adapted to a modified MR-couch simultaneously serving as tabletop for the operating table. To allow shock-free transport into the scanner the wheels of the operating table were replaced by an air cushion mechanism. In 75 procedures the system proved to be reliable and safe. Image quality was not impaired by the fixation device. With growing routine the transfer became straightforward, requiring approximately 10 min. Intra-operative MRI is thus made possible with minimal changes to the standard surgical environment. Its benefit however, still remains to be critically investigated.
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Perioperative nursing is still a much neglected area among the various fields of direct nursing care. This investigation was carried out within a framework of reevaluation and actualization of this area of care. The results show that in particular because of the working conditions of perioperative nursing high standards of professionally both with respect to details of care as well as to recognition of the overall situation of a patient are required.
BACKGROUND: Observation of the surgical field from all directions is essential in microneurosurgery. A tilting operating table operated by the surgeon can satisfy this need. METHODS: A tilting operating table operated by the surgeon using a foot switch was developed by modifying the Sugita table incorporating the X-Y shifter. RESULTS AND CONCLUSIONS: The modified operating table allows the surgeon to move the patient in the head up or down directions, as well as the left side down or right side down directions, so the surgical field can be inspected from all aspects without changing the vertical axis of the operating microscope.
Operating tables evolved rapidly from 1860 through 1920. By 1920, the operating tables were well-designed for a wide variety of operations. Today, our operating tables resemble those developed in the early 20th century.
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Four hundred and forty-six general, vascular and gynaecological surgical patients were recruited to a two centre, double triangular sequential randomised controlled trial to compare the post-operative pressure sore incidence in patients positioned on the standard operating table mattress with those positioned on the dry visco-elastic polymer pad (Action Products Inc.). Two hundred and twenty two patients were randomised to the experimental group and 224 to the standard mattress. The main endpoint failure rate (a pressure sore) was found to be 11% (22/205) for patients allocated to the dry visco-elastic polymer pad and 20% (43/211) for patients allocated to the standard operating table mattress. There was a significant reduction in the odds of developing a pressure sore on the dry visco-elastic polymer pad as compared to the standard, [symbol see text] = 0.46 with 95% confidence interval of (0.26, 0.82), P = 0.010. The adjusted point estimates of the probability of developing a pressure sore on the dry visco-elastic polymer pad and the standard operating table mattress were 0.11 and 0.21 respectively.
Two tables are described which are specially suited for neurosurgical operations. One has a fixed column and a removable table-top and the other is a mobile, battery-powered table. The facilities include different positions with special neurosurgical accessories for positioning anatomically adapted to the patient's body and for maximum stability of the operating field.
AC and DC powered operating tables were investigated from the viewpoint of safety and the following results were obtained: 1) With the increase in supply voltage, leakage from cables increased prominently. Only a low leakage cable showed a low leakage value. 2) AC powered operating tables showed a high leakage current, especially when in remote control. 3) A battery powered operating table with freely removable driving base and detachable table top function, which we developed, proved to have a satisfactory durability for actual clinical use and an extremely low level leakage of electricity (0.1-0.3 micro A). Moreover, our design incorporates every merit guaranteed by the usual operating table.
Analysis of current medical and engineering requirements for operating tables for adults and children is presented. Special attention is paid to the classification of operating tables, to the requirements for their design, operation, and service. Future trends in development of operating tables are discussed.