All cases with breast autologous fat grafting (AFG)
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:
None
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
Liposuction Tumescent Solution for Fat Graft harvesting:
LR 1L + 2g Epinephrine (2 amps of 1:1000)
Warm in towel warmer
Ancef 1g and Vancomycin 1g reconstituted into 10mL syringes to “squirt” from off the field to on the field – into the fat graft solution before Dr. Brown injects the fat.
Patient Position
Supine
The bed must be able to sit up 90 degrees for visualization of symmetry
One pillow under patient’s knees
Foam pad wrapped around patient’s heel
If prone – patient will need to have two chest rolls and a roll horizontal on the bed underneath their hips
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
Breast & Body
Microaire Liposuction Handpiece, “Purple” Power Box, Power cord, Cannulas
Surgical Packs
Breast or Body Pack, depending on concomitant surgery
Surgical Prep
Chloraprep x 5 – place in fluid warmer prior to use
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
Not mandatory, but can assist with keeping the patient clean
Blades
15 x 1
11 x 1
Bovie
Not needed for liposuction and fat grafting independently
Drains
10mm perforated flat JP drain, on trocar if available x 1 if prone
100mL bulb suction x 1
Additional Supplies
Marking pen x 6
Paper Ruler
Infusion tubing (to pump in tumescent fluid)
Liposuction tubing
Infusion/Peristaltic Pump (to pump in tumescent fluid and fat)