Blepharoplasty
Rib Harvest
Describe procedure
01 - Patient Setup
02 - Instrument Sets
Pre-op Meds: Ancef or Clindamycin, Decadron 8 mg, Tranexamic acid
Anesthesia: General, ETT off ;pt's left side about 2cm from commisure
Patient position: Supine
Bed position: 90° (R side of patient facing surgeon, L side facing anesthesia)
DVT ppx: Compression boots on - working BEFORE induction of anesthesia
Side Table: Prep table includes 10 mL 1% lidocaine, 1/100 K epinephrine, 27 gauge needle, speculum, packing forceps, 6 nasal pledges soaked in Afrin, scissors
Lights: Surgical headlamp for surgeon
Bovie Settings: 10-10, Colorado Tip
Preinjection: See "Side Table"
Prep: Ophthalmic Betadine
Drapes: 4 towels w/ split sheet
Instrument sets: Tebbets rhinoplasty set, septoplasty set
03 - Case Details
Special Instruments: Carving block + grid, graft templates, dorsal nasal sizers.
Devices/Implants: None
Meds on field: Afrin (20cc) and 10cc syringe with 16 angiocath tip
Hypodermic needles: 27 gauge
Syringes: 10 mL w/ 1% lidocaine, 1/100 K epinephrine
Drains: none
Suture: 5-0 PDS undid cutting small needle, 6-0 praline taper, 4-0 plain gut straight needle, 5-0 chromic RB-1
Anesthesia on field: 10 cc 1% lidocaine 1-100 K epinephrine
Dressing: benzoin + 0.5 in Steri-Strips cut by surgeon
04 - Post-Op Information
Admission status: SDS
Estimated time: 2 hrs
Coding: ICD-9 478.19, 470.0, 905.0. CPT ask surgeon
Post-op wound care: Minimize nose bleeding, knees w/ open mouth, drip pads for bleeding.
Post-op activity restrictions: No vigorous activity for 2 wks
Follow up: 1 wk