Traumatic experiences are highly prevalent and often cause longstanding impacts on individuals’ mental and physical wellbeing. The six core principles for providing trauma-informed care (TIC) include 1) safety, 2) trustworthiness and transparency, 3) peer support, 4) collaboration and mutuality, 5) empowerment, voice, and choice, and 6) cultural, historical, and gender issues. Gynecologic TIC has been adopted in the outpatient setting, but not in perioperative care. We aim to review best practices related to TIC and provide strategies for implementation in the operating room.

Design:

Descriptive video based on clinical experience and review of literature.

Setting:

NA

Patients or Participants:

Individuals who screen positive for history of trauma undergoing gynecologic surgery.

Interventions:

We demonstrate perioperative strategies for providing TIC.

Measurements and Main Results:

We recommend universal preoperative screening for history of trauma. Prior to surgery, identified individuals may be offered behavioral health consultation to review perioperative needs and perform imaginal exposure and grounding. Patients should be consented in clinic to minimize logistical stress in the surgical area. When patients arrive for surgery, they should present the care plan, created preoperatively, to notify perioperative staff members. Patients can be offered gowns and scrub pants to minimize bodily exposure and encouraged to utilize music and other comfort measures. In the operating room, we recommend doorway signage to minimize traffic, covering instrument tables, and dimming room lights. The surgical stirrups should be placed on the bed after the patient is asleep. Patients should be offered to place the safety strap and hold the oxygen mask themselves. Once in recovery, patients should be offered a private room, if feasible, and a support person can present to bedside early to help ease the transition to recovery.

Conclusion:

Patients with a history of trauma, undergoing Gynecologic surgery, are at risk for re-traumatization. We demonstrate simple and supportive steps for advancing TIC practices before, during, and after gynecologic surgeries.