Lower Extremity Reconstruction Preference Card

  • This Card is to be used for lower extremity reconstruction with the following:

    • ALT free flap

    • Latissimus free flap

    • Gracilis free flap

    • Radial Forearm free flap

  • Dr. Brown:

    • Gown – XL, XL Length

    • Gloves – 8 Indicator Glove, 7.5 Biogel Glove

  • Dr. Chandler:

    • Gown – L

    • Gloves – 5.5, 6.0 if 5.5 unavailable

  • Sean Kirby PA-C:

    • Gown – XL

    • Gloves – 7.5 Indicator Glove, 7 Nonlatex Glove

  • Pre-operative Medications:

    • Lovenox 40mg to be injected in preop prior to rolling to OR to be injected in thigh

  • Intra-operative Medications

    • Ancef 2 grams IV or Vancomycin 1g IV to be administered in pre-op prior to procedure

    • Infiltration Solution (PHARMACY TO PREPARE, IN PRE-OP ORDERS):

      • NS or LR 500 mL

      • Ropivicaine 300mg

      • Clonidine 0.3mg

      • Dexamethasone 4mg

    • Heparin Solution (PHARMACY TO PREPARE, IN PRE-OP ORDERS:

      • Heparin 10000 units in 500mL normal saline – place in 10mL syringe with 24 angiocath tip

    • Papaverine 30mg/mL – 2mL in 3mL syringe – have in room but do not open

  • Patient Position

    • Supine

    • One pillow under patient’s knees

    • Foam pad wrapped around patient’s heel

  • Bed Attachments

    • Arm boards with purple pads underneath arms and then wrap the arms in Kerlix

  • Patient Warming

    • Blanketrol, Arctic Sun, or underbody warmer

    • IV fluid warmer

    • Sterile fluid warmer with 2L of Normal Saline

  • DVT Prophylaxis

    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.

  • Foley Catheter

    • Yes – have tubing run down leg and secured in SCD

  • Instrument Sets

    • DIEP Set

    • Microsurgery Set

    • Body Set

  • Surgical Packs

    • DIEP/Micro Pack

    • Body Pack

  • Surgical Prep

    • Chloraprep x 5 – place in fluid warmer prior to use

    • Please use Iodine paint if open wound is present

  • Irrigation Solutions

    • Warmed Normal Saline (as mentioned in patient warming)

    • 1L sterile water in basin for washing instruments

    • Iodine/Antibiotic Solution:

      • Ancef 2g

      • Gentamycin 160mg

      • 100mL of full strength 10% stock providone-iodine (This is PAINT not scrub)

      • Mixed into 1L Normal Saline

  • Suction

    • When under the microscope, turn one suction system to low suction power

  • Blades

    • 10 x 4

    • 15 x 1

    • 11 x 1

  • Bovie

    • Short Protected ENT tip  x 2

    • Long Protected ENT tip x 1

    • Set at coagulate 40 fulgurate /  cut 40 pure

    • Bipolar x 2 

    • Will need two BOVIE and two BIPOLAR for case

  • Drains

    • 15Fr Round JP drain, on trocar if available x 3

    • 100mL bulb suction x 3 

  • Additional Supplies

    • Marking pen x 6

    • Paper Ruler x 2 

    • Eight (8) AA batteries for the Flow Coupler Black Box

    • Flow Coupler Black Box

    • Flow Couplers, Sizes 2.0, 2.5, and 3.0 (must keep minimum of two of each)

    • Regular Coupler Devices, Sizes 1.5, 2.0, 2.5, 3.0, 3.5 (must keep minimum of two of each)

    • Lonestar x 2

    • Weck Cel x 1 pack

    • Merocel x 1 piece

    • Bulldog Vessel Clamps – one single and one double

    • Synovis Microsurgery Background

    • 8-0 Nylon Suture x 3, Mfr#2808G

  • Dressing

    • Mastisol x 4 

    • 1 inch steri strips x 3 packs

    • Xeroform x 2

    • Kerlix x 2 

    • 4in ACE wrap x 2

    • Have cast cart with 4in plaster wrap and soft roll wrap in room

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