To the Editor:—
We wish to report a useful technique for positioning infants requiring surgery in the prone position, using a commonly available adult Scheie headrest (fig. 1; Sunrise Medical, part No. 8815, Baldwyn, MS). After anesthetic induction etc. , the infant’s torso is placed prone in the concave cavity of the headrest, and the head is supported on a soft foam, gel, or surgical headrest (fig. 2). Because the base of the device is flat, it provides a stable support that will not slip or move as occurs if cloth or foam rolls are used. The polyurethane foam is rigid enough to support the infant, but pliable enough not to compress the tissues. The T-shaped cutout allows free movement of the abdomen, avoiding compression and secondary venous congestion.
This technique is useful for procedures on both the lower and the upper back, as well as the posterior fossa of the skull. For cervical spine or posterior fossa operations, the neck can easily be flexed by elevating the support. The arms may be positioned at the infant’s side or along the head, depending on the site of the operation. Padding should be used for the extremities as needed.
Monitor cables are directed away from the site of surgery. A forced-air heater may be placed above or below the device to facilitate temperature control. The technique is useful for any infant who fits comfortably in the cradle.