Facial Soft Tissue Trauma – Debridement and Closure

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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
  • 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).  OR scheduled antibiotics.
    • Decadron IV by anesthesia
    • Toradol IV by anesthesia
    • Infiltration Solution (Dr. Brown will inject):
      • NS or LR 500 mL
      • Ropivicaine 300mg
      • Lidocaine 500mg = 50mL of a 1% solution
      • Clonidine 0.3mg
      • Dexamethasone 4mg
    • Nitrobid ointment to rub on devitalized skin flaps.  2 packs in room.
  • Post-operative Medications (Prescribed pre-op)
    • Tylenol 650mg 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
    • Refresh tears
    • Refresh PM ointment
  • Anesthesia
    • Anesthesia choice
  • Patient Position
    • Supine, turn bed 90 degrees
  • Bed Attachments
    • Tuck Arms
  • Patient Warming
    • Bair Hugger
  • DVT Prophylaxis
    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
  • Foley Catheter
    • No
  • Instrument Sets
    • Face
  • Surgical Packs
    • Face
  • Surgical Prep
    • 5% Betadine for face
  • Irrigation Solutions
    • Warmed Normal Saline in basin
    • Hydrogen Peroxide in basin
    • 1L NS or LR hooked up to battery powered pulse lavage
  • Blades
    • 15 x 2
    • 11 x 1
    • 10 x 2
  • Bovie
    • Colorado tip
    • 20/20 pure and fulgurate
  • Suture Available
    • 4-0 Monocryl Large cutting x 2
    • 5-0 Monocryl Large Cutting x 2
    • 4-0 Plain Gut Large cutting x 1
    • 5-0 Fast Gut Large cutting x 1
    • 6-0 Fast Gut Large cutting x 1
    • 5-0 Nylon Large cutting x 1
    • 6-0 Nylon Large cutting x 1
  • Drains
    • 10 mm flat Drain on Trocar with 100 mL  bulb suction in room
  • Additional Supplies
    • Marking pen, Paper Ruler x 4
    • SPY MACHINE and kit (drape and dye)
  • Dressing
    • Bacitractin
    • BSS eye irrigation or any Eye saline solution
    • Refresh PM eye ointment or Erythromycin ophthalmic
    • Xeroform
    • Kerlex
    • 4″Coban  x2
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