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Mandible Fracture

Surgical procedure to expose, reposition, and stabilize the mandible after trauma.

01 - Patient Setup

Pre-op Meds: Ancef or clindamycin, 8 mg Decadron, Tranexamic acid

Anesthesia:  General, hypotensive (MAP 55-60 mHg)

Patient position: Supine

Bed position: 90° surgeon away from anesthesia machine on patient's R side

DVT ppx:  Compression boots on - working BEFORE induction of anesthesia

Side Table: Xeroform strip gauze, 2-0 prolene, scissors, forceps, local anesthesia, alcohol wipe, large gloves, 4x4s

Lights: Surgeon headlamp

Power: Drill

Bovie Settings: 30-30 w/ Teflon guarded blunt tip

Preinjection: Inject 10 mL lidocaine 1% 1/100 K epinephrine into each side

Prep: Betadine on face, chlorhexidine in mouth

Drapes:  Jaw head wrap and 4 towels around face + split sheet (see jaw head wrap video)

Instrument sets: Stryker Mandible Set, Stryker SmartLock MMF, and elastics (24G wire, 26G wire in room but not opened: scrub tech please pre-stretch the wires)

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Head drape above
Nasal ETT sutured below

02 - Instrument Sets

Side table to suture ETT

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Special Instruments: Stryker Mandible Set, Stryker Smart Lock Hybrid MMF set

03 - Case Details

Special Instruments: Clear plastic self-retaining lip retractor

Devices/Implants: Stryker Mandible Set, Stryker Smart Lock Hybrid MMF set

Hypodermic needles:  27 gauge needle

Syringes: 10 mL syringe 

Drains: None

Suture: 3-0 chromic SH

Anesthesia on field: None

Dressing:  Jaw bra

 

04 - Post-Op Information

Admission status: A.M. admission

Estimated time: 2 hrs

Coding: Check w/ surgeon

Post-op wound care:  ___

Post-op activity restrictions:  ___

Follow up:  1 wk

 

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