HANDS FREE Foot controls ease staff's physical stress when they're raising or lowering the surgical table.

Today's surgical tables are more versatile than ever, giving you plenty of affordable options for promoting staff safety, protecting patients and improving surgeon comfort. Let's take a look at 5 factors that will help you determine which features are the right fit for your orthopedic cases.

ADDED BENEFIT A table's accessories should be lightweight and easy to attach.

1 Maneuverability
If you're performing orthopedic procedures at your facility, your table must be able to tilt into the Trendelenburg position. In addition, tables with an adjustable height let surgeons place themselves into ergonomically ideal positions to access the surgical site during a variety of procedures. From a safety standpoint, the ability to lower and raise the table lets nurses more easily and safely transfer patients from the table's surface to stretchers, and vice versa.

Many manufacturers' tables now feature greater low-to-high capabilities, which ease the burden for your surgical team. Say, for instance, that you have a patient on a Wilson frame that increases the height of the table. The lower position of modern tables lets the surgical team more easily access the surgical site, which sometimes eliminates the need for stepstool lifts — a key benefit from a surgical team safety standpoint. In addition, the ability to place the table at a higher position for other orthopedic procedures lets taller surgeons operate from a more comfortable position.

2 Weight capacity
With more overweight and obese patients presenting for surgery, a table's sturdiness and weight capacity become more critical. Not long ago, most surgical tables could support up to 300 lbs. Today's standard tables, however, can support 400 lbs. or 450 lbs. Keep in mind that you need a table that can raise and lower larger patients, and not just hold them. With weight ratings of 700 lbs. to 1,000 lbs., many tables now feature wider tabletops. Always remember, however, that the total weight a table can raise and lower may differ from its articulation weight, which is the (sometimes smaller) amount of weight the table can hold while tilting or shifting.

3 Surface pads
The material of your table's surface pads should be compatible with the type of cleaning and disinfection solutions your staff uses. The table should also be easy to clean, since microorganisms can linger on its surface, leaving the patient vulnerable to potential surgical site infections. Consult with your table vendor as well as your environmental services team on the types of cleaning materials that can be used on the table's pads.

The material and thickness of the table pads are also important patient safety considerations. Tables have historically come with foam rubber pads covered with vinyl that are at least 2 inches thick to help prevent pressure sores. Today's table pads are often thicker, even if only by an inch or so, and some tables include pads with memory foam that increases the pads' viscosity and density.

4 Motorization
If your surgical tables must be frequently moved from one OR to another, a motorized surgical table may be the way to go. As part of a vendor's demonstration, ask to review a table's pendant control to measure ease of operation. For example, does the motorized table have pre-set positions? How easily and quickly can the table be returned to the normal supine position?

Also look at whether the table's pendant has back lighting, which is a helpful feature to have in darkened rooms during minimally invasive procedures. Many models now have wireless pendants available. A pendant that's attached to the table isn't always easy to reach once the patient is draped for surgery. Naturally, a wireless pendant alleviates this problem, and makes adjusting the table easier. Many tables now feature foot controls as well, which let the surgeon raise and lower the table during the procedure while keeping his hands free and focus on the job at hand.

5 Attachments
Ease of use is the key to evaluating today's table accessories and extensions. Is the device easy to place and remove? Is it light enough to prevent injuries to employees? Some newer extensions and accessories — leg holders, lower extremity extensions, shoulder extensions, upper arm extensions — make it possible to perform orthopedic procedures by attaching the accessory to an existing general OR table. Consider adding a cart to manage table accessories. Carts can be labeled with pictures and designated spots for each item, which greatly aids staff in finding accessories quickly while setting up the room.

Shoulder "beach chair" attachments provide easier patient positioning and access for all shoulder procedures. The handles on either side of the chair attachment should be easy to attach and remove, and side panels should be removeable to accommodate either a left or right shoulder procedure. Most shoulder chair attachments are manually controlled and manipulated, but some feature motion-control technology that lets you position patients with the push of a button, completely eliminating the need to do so manually.

Now and later
The process for choosing the best orthopedic surgical table should depend on the type of procedures you're performing now as well as those you plan on adding or expanding in the future.

Depending on your budget and orthopedic case volume, adding accessories to your general surgical table may cost less than purchasing more expensive fixed-base surgical tables, which can run about $125,000. A fixed-base table, however, may fit into your long-range plans. For example, do you plan to increase the number of minimally invasive procedures your surgeons perform such as anterior incision hip arthroplasty? In the end, a combination of both types of tables — along with the necessary accessories for the full range of orthopedic procedures — may be the more economical choice.