Debridement or Incision and Drainage

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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
    • In pre-op holding ~1 hour before surgery:
      • Tylenol 975mg PO x1
      • Gabapentin 600mg PO x1
      • Celebrex 400mg PO x1
  • Intra-operative Medications
    • Continue Schedule Antibiotics OR
      • 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 – if muscle involved
    • Gabapentin 300mg PO q6 hours scheduled
    • 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
  • Bed Attachments
    • Depends on location of wound
  • Patient Warming
    • Bair Hugger
    • Underbody warmer vs Arctic Sun
  • DVT Prophylaxis
    • Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
  • Foley Catheter
    • No
  • Instrument Sets
    • Minor plastic surgery set (sharp rakes, curved mayos, needle drivers, skin hooks, sharp rake retractors, army navys, Richardsons
    • Lehey clamps
    • Large Currettes
    • Large Rongours
  • Surgical Packs
    • Universal or extremity, depending on location of wound.
  • Surgical Prep
    • Chloraprep where there are no open wounds
    • Betadine scrub and Paint around open wounds
    • 5% Betadine for face
  • Irrigation Solutions
    • Warmed normal saline
    • Hydrogen Peroxide mixed 50-50 with normal saline
    • 3L NS or LR via Pulse Lavage
  • Blades
    • 15 x 1
    • 11 x 1
    • 10 x 1
  • Bovie
    • Short Protected ENT tip x 1
    • Set at coagulate 60 fulgurate /¬† cut 60 pure
  • Suture (in room, don’t open)
    • Do not open – depending on case
  • Drains
    • 10 mm flat perforated drain, on trocar, 100mL bulb suction
  • Additional Supplies
    • Marking pen, Paper Ruler x 4
    • Wound cultures (gram stain,¬†aerobic, anaerobic, fungal, AFB)
    • Specimen cup to send tissue to path
    • VAC with medium/large silver or black sponge
    • Mastisol
    • Adaptic or Xeroform in room
    • Binder if wound on trunk
    • Bra if wound on breasts
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