- This Card is to be used for:
- Delayed DIEP flaps
- Immediate DIEP Flaps
- 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
- Nitrobid ointment to rub on mastectomy skin flaps at the end of the case. Two (2) packs for each side.
- Patient Position
- Supine
- The bed must be able to sit up 90 degrees for abdominal closure
- 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
- Martin’s arm on the other side of the microscope
- 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
- Breast Set
- 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
- When under the microscope, turn one suction system to low suction power
- Bovie
- Short Protected ENT tip x2
- 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
- 10mm perforated flat JP drain, on trocar if available x 4
- 100mL bulb suction x 4
- Additional Supplies
- Marking pen x 6
- Paper Ruler x 2
- Ventrio Mesh Patch 11cm x 14 cm – TWO OF THEM
- 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
- Scale to weigh flaps
- Dressing
- Mastisol x 4
- 1 inch steri strips x 3 packs
- Mepilex Ag Border Dressing x 3