Introduction
In the realm of orthopedic, spinal, and neurosurgery, patient positioning is not merely a procedural step—it is a critical factor that impacts surgical outcomes, complication rates, and procedural efficiency. Among the various positioning aids, the surgical peg board plays a pivotal role in achieving optimal lateral positioning, especially during complex procedures such as hip replacements or spine corrections.
What is a Surgical Peg Board?
A surgical peg board, also known as a lateral positioner peg board, is a specialized operating table accessory designed to help securely position and immobilize patients in the lateral decubitus position. It consists of a radiolucent base board and a series of adjustable pegs or posts that can be inserted into the board to fit around a patient’s body contours.
Surgical Peg Board Positioner System Includes:
● Hole backplate
● Gel fixing rod
● Gel Fixing Rod
● Semi-circular support pad
● Open headband
● Pressure-reducing mattress
● Special storage box.
Key Features of a Surgical Peg Board
- Radiolucent Construction: Typically made of high-density, carbon composite or medical-grade plastic that allows for unobstructed imaging during intraoperative X-rays or fluoroscopy.
- Adjustable Pegs: The posts can be configured based on patient anatomy and procedural requirements, allowing for tailored stabilization.
- Non-Slip Surface: Ensures the patient remains secure during surgical manipulations and repositioning.
- Weight Capacity: Many peg boards are designed to accommodate bariatric patients, supporting weights of up to 500 lbs (227 kg) or more.
- Compatibility: Easily attaches to most standard surgical tables using clamps or integrated locks.
Applications in Surgery
Surgical peg boards are predominantly used in:
- Total Hip Arthroplasty (THA): Provides firm support to maintain pelvic alignment.
- Spinal Fusion and Laminectomy Procedures: Offers lateral spine exposure while reducing the risk of patient shift or pressure injury.
- Thoracic and Kidney Surgeries: Maintains proper torso elevation and stabilization for safe organ access.
Benefits of Using a Surgical Peg Board
1. Enhanced Patient Safety: Prevents intraoperative movement, reducing the likelihood of nerve damage or pressure ulcers.
2. Improved Surgical Access: Maintains precise anatomical orientation for better visibility and access to the operative site.
3. Versatility: Adjustable configuration accommodates a wide range of patient body types and surgical indications.
4. Efficiency and Consistency: Facilitates quick and repeatable setups, saving valuable operating room time.
Best Practices for Use
- Always perform a preoperative assessment of the patient’s body type and procedure type.
- Use padding and gel cushions around bony prominences to prevent pressure injuries.
- Confirm secure peg placement before draping and incision.
- Monitor and document patient positioning at regular intervals during long surgeries.
Maintenance and Cleaning
Given its direct contact with the patient, proper maintenance is essential. Most surgical peg boards are:
- Autoclavable or compatible with high-level disinfectants.
- Designed with smooth, seamless surfaces to prevent bacterial growth.
- Require routine inspection for cracks, warping, or loose peg holes to ensure safety and longevity.
Conclusion
The surgical peg board is a vital positioning device that enhances precision, safety, and comfort during lateral procedures. Whether used in orthopedics or neurosurgery, its adaptability and stability make it an indispensable part of modern operating rooms. Surgeons, nurses, and OR technicians must be well-versed in its application to ensure optimal patient outcomes and procedural success.
References
1. Pateder, D. B., & Kebaish, K. M. (2005). Surgical positioning in spine surgery: emphasis on complications and avoidance strategies. The Journal of the American Academy of Orthopaedic Surgeons, 13(7), 439-446.
2. AORN Journal. (2021). Positioning the Patient for Surgery. Association of Perioperative Registered Nurses.
3. Operating Room Setup Guidelines – OR Today Magazine. https://www.ortoday.com
4. Surgical Positioning Best Practices – Medline Industries. https://www.medline.com
