Prone Surgical Position

In the full horizontal prone position the patient rests horizontally facing the table, allowing maximum exposure of the posterior aspect of the body. The Prone Surgical Position used for Back or neck procedures (cervical to sacral), Procedures of the occipital or postero-lateral cranium Sacral, perianal & perineal procedures.
  • Anesthetized at supine, usually on the stretcher, prior to turning to Prone Surgical Position
  • Turning is synchronized and supported
  • Face down, resting on the abdomen and chest
  • 2 Chest rolls placed lengthwise under the axilla and along the sides of the chest from the clavicle to iliac crests (to raise the weight of the body off of the abdomen and thorax)
  • One roll is placed at the iliac or pelvic level
  • Arms lie at the sides or over head on arm boards (must lower arms slowly to the ground then bring them up in an arc to place on arm boards)
  • Head is face down and turned to one side with accessible airway
  • Forehead, eyes and chin are protected 
  • Padding to bilateral arms and under knees
  • Pillow placed under bilateral feet (for maintenance of foot extension)
  • Female breasts and male genitalia must be free from pressure and torsion
  • Safety strap placed above knees
Potential Complications of Prone Positioning

  • Compression ulcers:  orbital, ears, nose, elbows, iliac crests, knees, breasts and toes
  • Nerve damage:  axillary, brachial plexus, radial, ulnar,  popliteal, long thoracic
  • Thoracic outlet syndrome
  • Cervical Spine Injury
  • Breast trauma
  • Unstable chest wall
  • Venous congestion
  • Conjunctival edema
Safety Considerations of Prone Positioning

  • Maintain cervical neck alignment
  • Protection of forehead, eyes, chin
  • Padded headrest to provide airway
  • Chest rolls to allow chest movement and decrease abdominal pressure
  • Breasts and genitalia free from torsion
  • Padded with pillows
  • Padded footboard

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