Split Thickness Skin Graft

Print Card

  • Dr. Brown:
    • Gown – XL, XL Length
    • Gloves – 8 under glove, 7.5 over glove
  • Dr. Chandler:
    • Gown – L
    • Gloves – 5.5, 6 if no 5.5 available
  • Sean Kirby PA-C:
    • Gown – XL
    • Gloves – 7.5 Indicator Glove, 7 Nonlatex Glove
  • Pre-operative Medications (prescribed pre-op)
    • Night before:
      • Scopolamine patch placed behind ear
      • Shower with Hibiclens for couple days before surgery 4% topical chlorhexidine soap.
    • Upon check in for surgery:
      • Tylenol 975mg PO x1
      • Gabapentin 600mg PO x1
      • Celebrex 400mg PO x1
  • Intra-operative Medications
    • Ancef 2 grams IV (ok if allergic to Penicillins).   Vancomycin 1g IV (if allergic to Ancef)
    • Infiltration Solution (Dr. Brown will inject):
      • NS or LR 500 mL
      • Ropivicaine 300mg
      • Clonidine 0.3mg
      • Dexamethasone 4mg
  • Post-operative Medications (Prescribed pre-op)
    • Tylenol 650mg PO q6 hours scheduled
    • Methocarbamol 1500mg PO q6 hours scheduled
    • Gabapentin 300mg PO q6 hours scheduled
    • Cephalexin 500mg PO q6 hours scheduled for 4 doses starting after surgery
    • Celebrex 200mg PO BID scheduled (if not too expensive)
    • Pericolace 1 tab PO BID scheduled
    • Phenergan 25mg PO q8 hours PRN nausea
    • Oxycodone 5mg tabs, 1-3 tabs PO q4 hours PRN pain
    • Ibuprofen 600mg PO q6 hours scheduled, starting 48 hours after surgery
  • Anesthesia
    • Anesthesia choice
  • Patient Position
    • Depends on location of wound
    • Rotate table 90 degrees if extremity
  • Bed Attachments
    • Depends on location of wound
  • Patient Warming
    • Bair Hugger
    • Blanketrol, Arctic Sun, or underbody warmer
    • IV Fluid Warmer
  • DVT Prophylaxis
    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
  • Foley Catheter
    • No
  • Instrument Sets
    • Body
    • Large Curettes
    • Ronjour
    • Dermatome & Blade – 3 Guard on Blade
    • 1:1.5 Mesher & Carrier
  • Surgical Packs
    • Body or Extremity
  • Surgical Prep
    • Chloraprep x 2 – Used for Donor site, thigh
    • Betadine scrub and Paint in and around open wounds
  • Irrigation Solutions
    • Warmed Normal Saline
    • Sterile water in basin for washing instruments
    • Iodine/Antibiotic Solution:
      • Ancef 2g
      • Genamycin 160mg
      • 100mL of full strength 10% stock providone-iodine (This is PAINT not scrub)
      • Mixed into 1000cc Normal Saline
  • Blades
    • 11 x 1
    • 10 x 2
  • Bovie
    • Short Protected ENT tip x 1
    • Set at coagulate 60 fulgurate /  cut 60 pure
  • Suture (in room, don’t open)
    • 4-0 Monocryl Large cutting x 2
    • 4-0 Chromic large cutting x 2
    • 5-0 Chromic large cutting x 1
  • Drains (in room, don’t open)
    • 10mm perforated flat JP drain, on trocar if available, 100mL bulb suction
  • Additional Supplies
    • Marking pen
    • Paper Ruler
    • Wound cultures (gram stain, aerobic, anaerobic, fungal, AFB)
    • Specimen cup to send tissue to pathology
    • Wound VAC with medium-large silver or black sponge to bolster down skin graft
    • Mastisol
    • Adaptic or Xeroform to put on top of skin graft
    • Primatrix to put on skin graft donor site, followed by ABD pads and paper or foam tape.
    • Binder if wound on trunk
    • Bra if wound on breasts
Print Card