Industry commentary — August 2026
The supine position accounts for the majority of general surgical case volume worldwide — craniotomy, faciomaxillary, thyroid, breast, abdominal, vascular, and most extremity procedures. Because it is so routine, it is also the position where preventable harm is most often missed.
A supine patient's weight is borne by the occiput, scapulae, elbows, sacrum, and heels. Two of those sit over bone with almost no subcutaneous padding, which is why occipital pressure alopecia and heel pressure ulcers remain the two most-cited supine-position complications.
Full-table overlay, head ring (donut), and head pad selection for the supine patient.
The head-ring debate
For procedures requiring absolute head stillness, the head is fixed in a head ring (donut) or a C-shaped cradle. The ring must be sized correctly — pediatric rings are typically 3.5 cm tall, adult rings 5 cm. For procedures where the head is turned to one side, a concave head pad creates a pressure-free channel for the dependent ear.
Shoulders and arms
The shoulders should rest in slight abduction on a low-profile silicone shoulder pad. The arm should rest by the patient's side with the palm facing the body and the thumb up, with a single-use arm strap placed across the forearm — not the wrist — to avoid direct pressure on the radial and ulnar nerves. Gel arm pads cover the forearm from elbow to wrist.
Head protection, shoulder pad placement, arm restraint, and hand board for obese patients.
Hand boards for obese patients
In obese or heavily muscled patients, a hand board placed lateral to the hip keeps the arm abducted and the hand protected, while also bracing the surgeon's elbow during long abdominal cases.
FAQ
Why is the heel at higher risk than the sacrum? Because the calcaneus has almost no subcutaneous tissue between skin and bone; the skin bears the full load directly.
For more information about Red Sun Medizone surgical positioning systems and other operating-room equipment, please visit www.redsunmedizone.com or contact our sales team.
About Red Sun Medizone: Red Sun Medizone (Tianjin Huahong Technology Co., Ltd.) is a medical device manufacturer and exporter specializing in operating tables, surgical position pads, surgical lights, patient monitors, and in-vitro diagnostics. With CE, ISO 13485, and FDA certifications, the company serves healthcare facilities in over 60 countries worldwide.