VIEWS: 12 PAGES: 2 POSTED ON: 8/26/2011
103 BREAST REDUCTION - BILATERAL DR. CUADROS Note slightly different setups for Main OR and Day Surgery Updated October 3, 2010 PAGE 1 OPERATIVE TIME: 3 HOURS USUAL LOCATIONS: Pres Main, Pres Day, ASC, NMHH ASSISTANT: Yes, Cheryl or Gwen ICD9 CODE: 611.1 Breast hypertrophy CPT CODE:19318 Breast Reduction ANESTHESIA NOTES GA: ETT or LMA, Kefzol 1gm IV PATIENT POSITION | SETUP ! supine, 6 chux, arm s out on boards, covered with green towels and taped w/2" silk. ! Sequential teds ! tattoo kit: 22g needle, Kelly clam p, 3cc syringe 18g needle, 4x4, non-sterile gloves ! Bovie electrocautery m achine at head of bead w/ suction TABLE POSITION pillow under knees, table in sem i-recum bent position ROOM SETUP Pre-warm room and table EQUIPM ENT ! Lower body Baer hugger, m etric digital scale, ! large specim en containers or sm all suction canisters for weighing tissue ! bag decanter ! W rapping boards ! for Day surgery and ASC - need headlight SPECIALS Main OR need fluid warm er w/ plastic drape for Gwen PREP CHG prep set, down to blue chux PACKS and DRAPING - Day Surgery PLASTIC SURGERY PACK Day Surgery Laparoscopic chole drape (89233), [1-2] size 8 gloves for Dr. C, 7½ Biogel and 7½ blue for Gwen PACKS and DRAPING - M ain OR PLASTIC SURGERY PACK Laparoscopic chole drape, m ag pad,  quarter sheets,  m ayo stand covers,  sticky paper drapes, basic pack, 3 gowns,  size 8 gloves Triflex, extra Micro-cool gown, cassette cover, fluid warm er drape CAUTERY Bovie 50/50 pure with silver tip with Saf-T-Vac, bovie pad SUCTION  suction: regular with plastic Yankauer and Saf-T-Vac  suction tubing SOLUTIONS | IRRIGATION  liters Norm al saline,  liters sterile water NEEDLES | SYRINGES  20cc syringes,  long Quincke 22g spinal needles LOCAL ANESTHETIC Solution “C” 200cc - Mix 2%lidocaine w/epi 50cc + 0.5%Marcaine w/epi 50cc + NS 100cc M EDICATIONS ! Bacitracin ointm ent 2 oz ! m ethylene blue (to m ark before prep) 103 BREAST REDUCTION - BILATERAL DR. CUADROS PAGE 2 SETS TO OPEN Dr. C Plastic set, basin for Solution C INSTRUMENTS USED (ON M AYO STAND) O FORCEPS Martin 7x 8 tissue, 01 Adson, 03 Adson, regular adson O SCISSORS curved Mayo serrated, str Mayo, str Metz, O NEEDLE HOLDERS  Crile wood,  Mayo Hagar,  Olsen-Hagar O RETRACTORS none O KNIFE | BLADES  knife handles,  No. 10 blades O OTHER  Hem ostats for drains m etal kidney basins [bring for HHNM] !  m arking pens !  Asepto syringes !  non-disposable light handles (Main OR) !  No. 10 blades BP STERILE SUPPLIES !  Bag decanter ! m ed glasses ! Basin set ! Saf-T-Vac SPONGES and TOW ELS  Lap sponges, towel pack NON-STERILE SUPPLIES W rapping board, large or m edium baby powder  Sm all suction canisters for weighing No Type SN status M  3-0 Ethilon PS-1 1663 open M  2-0 Vicryl CT-1 J 945 open M  3-0 Vicryl SH J 416 open SUTURES M  4-0 Vicryl PS-2 J 496 open M  4-0 Monocryl PS-2 Y 426 open M  5-0 Plain gut P3 686 hold DRAINS  15 Fr. Round Blake drains with connectors and reservoir bulbs - 2188. DRESSINGS '  tongue blades '  ABD '  3x18 vaseline gauze '  6" Ace '  4x4 '  kerlix '  cut drain sponges '  safety pins POSTOPERATIVE Call for bed from GSU x1046 Baby powder to wrapping board, m edium or large Lift with 3 people Safety pin reservoirs to ace, m ark 1 & 2 with Sharpie NOTES weigh specim en on digital scale in sm all suction canister after zeroing. Record weight on board, chart operative report and card for Dr. C. TO TAKE TO HEART HOSPITAL # Saf-T-Vac suction catheter # m etal kidney basin # Dr.C gloves 7 ½ Protegrity Latex # wrapping boards DATES MODIFIED May 2006, August 2007, October 2007, April 2008. May 2009, Oct 2010
"103 BREAST REDUCTION - BILATERAL"