Mini Abdominoplasty

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  • 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
    • Night before:
      • Scopolamine patch placed behind ear
      • Shower with Hibiclens for couple days before surgery 4% topical chlorhexidine soap.
    • In pre-op holding ~1 hour before 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 (PHARMACY TO PREPARE, IN PRE-OP ORDERS)
      • NS or LR 500 mL
      • Ropivicaine (Naropin) 300mg
      • Clonidine 0.3mg
      • Dexamethasone 4mg
  • Post-operative Medications (Prescribed pre-op)
    • Tylenol 650mg PO q6 hours scheduled
    • Methocarbamol 1500mg PO q6 hours scheduled
    • Celebrex 200mg PO BID scheduled
    • Gabapentin 300mg PO q6 hours scheduled
    • Cephalexin 500mg PO q6 hours scheduled for 4 doses starting after surgery
    • 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
    • GETA.  Will need paralysis during abdominal wall plication.
  • Patient Position
    • Supine.  Will need to reflex hips during closure.
  • Bed Attachments
    • Arm boards, Ulnar nerve pads.
  • Patient Warming
    • Lower BodyBair Hugger AND upper body bair hugger OR underbody warmer
    • IV fluid warmer for anesthesia
  • DVT Prophylaxis
    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
  • Foley Catheter
    • YES. Please have catheter running down leg and secured via SCD.
  • Instrument Sets
    • Breast & Body or Minor plastic set.
    • Need long narrow retractor for abdominal plication
  • Surgical Packs
    • Body
  • Surgical Prep
    • Chloraprep    Will need 4 sticks, pre-warmed in towel warmer.
  • Irrigation Solutions
    • Warmed Normal Saline
    • Sterile water in basin for washing instruments
    • Standard irrigation solution (PHARMACY TO PREPARE, IN PRE-OP ORDER SET)
      • NS 1L
      • Ancef 2g
      • Gentamicin 160mg
      • Betadine Paint (10% Povidone-Iodine) 100mL
  • Blades
    • 15 x 2
    • 10 x 2
  • Bovie
    • Short Protected ENT tip x 2
    • Long Protected ENT tip x 2
    • 60/60 cut pure and coat fulgarate
  • Suture
    • #1 Prolene on a large taper needle  x2
    • Large Stratafix which we will bring from office – do not open
    • 2-0 PDS Large taper  x 6
    • 3-0 Monocryl Large cutting x 4
    • 3-0 v-Loc (absorbable) Long, Large Cutting x 2
    • 4-0 Plain Gut Large cutting – have in room but do not open
    • 2-0 Nylon Large cutting x 2 for drain
  • Drains
    • 10mm flat perforated JP drain on tracer. 100mL Bulb suction.
  • Additional Supplies
    • Marking pen, Paper Ruler x 4
  • Dressing
    • Mastisol
    • Wide Long Steri strips
    • Xeroform for umbilicus
    • Kerlex to fluff under abdominal compression garment

 

  • Important Post Operative Pearls:
    • Transfer to stretcher KEEPING the patient in the reflex position.
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