Commentary |

Use of a Saline Bag as a Shoulder Roll During Surgery Not Recommended

Ronald C. Pearlman, PhD
Arch Surg. 2009;144(10):892. doi:10.1001/archsurg.2009.164.
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In some hospitals, the use of a saline-filled bag covered with a blue operating room towel is often used as a shoulder roll to lift the shoulder and extend the neck during various surgeries. During one surgical case, a leak in the saline bag resulted in severe burns where the shoulder roll was placed.

A 47-year-old woman had surgery for thyroid goiter and was positioned for surgery by extending the neck using a shoulder roll. The roll consisted of a saline bag wrapped in a blue surgical towel. A foam, doughnut-shaped headrest helped keep the head supported and prevented hyperextension. A Valleylab Electrosurgical Generator (Boulder, Colorado) was used to gain exposure to the thyroid gland. One ground electrode for the electrosurgical unit was placed on the patient's thigh to complete the unit's circuit. The patient return electrode used was recommended by the manufacturer and was applied to hair-free skin.

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Figure 44-1. Anatomy of the Shoulder