Wenk Manuel, Pöpping Daniel, Henning Martin, Wenk Melanie, Liljenqvist Ulf, Möllmann Michael
Department of Anesthesiology and Intensive Care, University Hospital Münster, Münster, Germany.
Paediatr Anaesth. 2009 Jun;19(6):587-92. doi: 10.1111/j.1460-9592.2009.03008.x.
Positioning the head of patients undergoing procedures in lateral or prone position remains a difficult task for the anesthesiologists. Associated risks have attracted increasing attention because they range from minor facial soft tissue injuries to catastrophic complications such as stroke or postoperative blindness. Earlier, we reported on the use of a boxing sports helmet for simple and easy positioning of the head. However, as available helmets are limited in sizes and materials, that system is not easily transferable to children. Therefore, we sought to create a face and head protection device for children undergoing procedures in prone position.
METHODS/MATERIALS: We re-engineered a standard boxing sports helmet making it suitable as an on-head support cushion. By using WHO standard growth charts, various sizes were calculated and prototypes of different foam materials produced. Facial surface pressures were measured in 15 volunteers.
A lightweight foam-based face mask was created. Minimum necessary foam thickness was 2.5 cm. Different materials were tested and pressure in different facial zones never exceeded 30 mmHg.
Bringing a face protection device onto the patient's face instead of placing the face into support cushions is an elegant way of keeping control over airway devices and providing support for facial structures in various positions simultaneously. Skin surface pressure on facial structures remained low due to the specific mask design and choice of foam materials, which could lead to decreased incidences of undesired sequelae of prone position such as skin damage or even more devastating complications.
对于麻醉医生而言，在手术过程中为处于侧卧位或俯卧位的患者摆放头部位置仍是一项艰巨的任务。相关风险已引起越来越多的关注，因为其范围从轻微的面部软组织损伤到诸如中风或术后失明等灾难性并发症。此前，我们报道了使用拳击运动头盔来简单轻松地摆放头部位置。然而，由于现有的头盔在尺寸和材料方面存在限制，该系统不易应用于儿童。因此，我们试图为接受俯卧位手术的儿童创建一种面部和头部保护装置。
方法/材料：我们对标准拳击运动头盔进行了重新设计，使其适合作为头部支撑垫。通过使用世界卫生组织的标准生长图表，计算出各种尺寸，并制作了不同泡沫材料的原型。在15名志愿者身上测量了面部表面压力。
制作出了一种轻质泡沫材质的面罩。所需的最小泡沫厚度为2.5厘米。对不同材料进行了测试，不同面部区域的压力从未超过30毫米汞柱。
将面部保护装置放置在患者面部，而不是将面部放入支撑垫中，是一种巧妙的方法，既能控制气道装置，又能同时为不同体位下的面部结构提供支撑。由于特定的面罩设计和泡沫材料的选择，面部结构上的皮肤表面压力保持较低，这可能会降低俯卧位不期望的后遗症发生率，如皮肤损伤甚至更严重的并发症。
