Abdominoplasty NO Liposuction (this is rare)

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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 (Dr. Brown will inject at beginning of case):
      • 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
    • Celebrex 200mg PO BID
    • 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
    • Place Chloroprep sticks into towel warmer.
    • IV fluid warmer for anesthesia
  • DVT Prophylaxis
    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
  • Foley Catheter
    • YES. Please secure in SCD.
  • Instrument Sets
    • Breast & Body or Minor plastic set.
    • Need long narrow retractor for abdominal plication
  • Surgical Packs
    • Universal pack
  • Surgical Prep
    • Chloraprep. Will need 4 sticks, pre-warmed in towel warmer.
  • Irrigation Solutions
    • Room Temp Normal Saline
  • Blades
    • 10 x 2
  • Bovie
    • Short Protected ENT tip x 2
    • 60/60 pure and fulgarate
  • Suture
    • #1 Prolene on large taper needle x 2
    • 2-0 PDS Large taper x 3
    • 3-0 Monocryl Large cutting x 3
    • 3-0 v-Loc (absorbable) Long, Large Cutting x2
    • 4-0 Plain Gut Large cutting x1
    • 2-0 Nylon Large cutting x 2 for drain
  • Drains
    • 10mm flat perforated Drain on Trocar with 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 binder
  • Transfer to stretcher KEEPING the patient in the reflex position.
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