title: Prevention of facial pressure ulcers using the Mayfield clamp for sacral tumor resection.
abstract: Sacral neoplasm resection is managed via partial or total sacrectomy that is performed via the Kraske approach. The combination of the patients positioning and the relatively long operative time required for this procedure increase the risk of pressure ulcers. Facial pressure ulcers can cause tissue necrosis and/or ulceration in a highly visible area, leading to a cosmetically disfiguring lesion. Here, the authors report the use of a Mayfield clamp in the positioning of patients undergoing sacral tumor resection to prevent facial pressure ulceration. After the patient is placed prone in the Kraske or Jackknife position, the hips and knees are flexed with arms to the side. Then while in the prone position, the patient is physically placed in pins, and the Mayfield clamp is fixated at the center of the metal arch via the Mayfield sitting adapter to the Andrews frame, suspending the head (and face) over the table. The authors find that this technique prevents the development of facial pressure ulcers, and it has the potential to be used in patients positioned in the Kraske position for other surgical procedures.
authors.affiliation: Department of Neurosurgery, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: C Rory
authors.initials: CR
authors.lastname: Goodwin
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Recinos
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Omeis
authors.forename: Eric N
authors.initials: EN
authors.lastname: Momin
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Witham
authors.forename: Ali
authors.initials: A
authors.lastname: Bydon
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Wolinsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004867:Equipment Design; D005148:Facial Dermatoses / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation*; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000295:instrumentation*; D011183:Postoperative Complications / Q000517:prevention & control*; D003668:Pressure Ulcer / Q000517:prevention & control*; D016684:Prone Position; D012447:Sacrum / Q000601:surgery*; D013125:Spinal Neoplasms / Q000601:surgery*; D013525:Surgical Instruments; D055815:Young Adult