- This Card is to be used for:
- All cases with:
- breast augmentation
- breast mastopexy
- breast augmentation-mastopexy
- breast fat grafting during mastopexy or revision
- breast capsulectomy
- breast capsulotomy
- breast reduction
- breast implant exchange
- second stage breast revisions following reconstruction
- breast tissue expander with ADM
- breast tissue expander exchange for implant
- 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:
- 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
- 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
- Breast Set
- It is MANDATORY to have a long lighted retractor, with appropriate matching cord, and light source
- Surgical Prep
- Chloraprep x 4 – 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
- Medium Suction with Yankeur tip
- Bovie
- Short Protected ENT tip x 2
- Long Protected ENT tip x 1
- Set at coagulate 40 fulgurate / cut 40 pure
- Drains
- 10mm perforated flat JP drain, on trocar if available x 2
- 100mL bulb suction x 2
- please have in room but DO NOT open
- Additional Supplies
- Marking pen x 6
- Paper Ruler x 2
- If tissue expanders and ADM – facility will place order – PLEASE verify and contact PA when expanders and ADM are present
- If insurance breast reconstruction or implant exchange – facility will place order – PLEASE verify and contact PA when expanders and ADM are present
- If cosmetic – PA will provide the following
- implants
- implant funnel
- bra
- Please have two sitting stools, one for each side of the table
- It is MANDATORY to have a long lighted retractor, with appropriate matching cord, and light source
- Please have two small “credit card” size Tegaderm to cover the nipple
- Dressing
- Mastisol x 4
- 1 inch steri strips x 3 packs