Fat Grafting to Breast Preference Card

  •  This Card is to be used for:
    • 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)
    • 60mL Toomey syringes x 4
    • Davol Sputum Catch or Leukins Trap x 3 
    • Telfa Sheet x 4
  • Dressing
    • 2 x 2 Band-Aid for lipoports
    • Gauze if draining significant liposuction fluid

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