Bilateral breast reduction

By Dr. Kevin Han

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GLOVES:   6.5 Micro Indicator/6.5 Micro.

ANESTHESIA:    General, Ancef, Clindamycin if PCN ALLERGY, SCD’S on and working before induction, ET Tube or Flexible LMA only (NO REGULAR LMA)

PREP:  CHOLORAPREP BREAST BILATERAL, PREP CHIN TO UMBILICUS; Q-TIP TO UMBILICUS, TUCK 1 STERILE BLUE TOWEL ALONG EACH SIDE, LEAVE TOWELS TUCKED @ SIDE AFTER PREP. DO NOT SCRUB OFF MARKINGS.

POSITION:  Regular OR Bed, SUPINE, PILLOW UNDER KNEES, FOAM UNDER HEELS, TOWELS, BLUE CHUX. MAKE SURE BED SITS PATIENT UP TO 60 DEGREES (Hips at Bed Crease) , WILL SIT PT UP INTRA-OP, ARMS TUCKED, PALMS DOWN.  PADDED ELBOWS, WRISTS, HANDS.  DONUT FOR HEAD. (4 ABD pads to pad elbow and wrist)

MEDs: 1000ML NACL (IRRIGATION)

1% XYLOCAINE WITH EPI 1:100,000 (On Sterile TABLE) (30ML)

INSTRUMENTS: MAJOR PLASTIC SET, Nipple Cookie Cutters/areola marker (38 and 42)

EQUIPMENT:  BOVIE (40, 40, BLEND 3) x2 machines, BAIR HUGGER (LOWER), SCALE for Breasts Weight, Sitting Stools on right and left side of patient available

SUPPLIES:  

  • STAPLER (OPEN)
  • Marking Pen x 2
  • Ruler
  • #10 BLADE (2)
  • Surgical Laps (OPEN)
  • 2 Bovie and machines with unprotected tips
  • 25 GAUGE HYPO (2)
  • 7FR, 15FR OR 19 FR BLAKE DRAINS (2, AVAILABLE)
  • JP BULBS (2, AVAILABLE)

SUTURES: 

  • 3-0 PDS SH (2) (AVAILABLE)
  • 3-0 MONOCRYL PS-2 (4) (OPEN)
  • 4-0 MONOCRYL PS-2 (2) (OPEN)
  • 5-0 FAST ABSORBING PC-1 (AVAILABLE)
  • 2-0 SILK FS (2, AVAILABLE FOR DRAIN STITCH) 

DRESSINGS:  One MEDIUM TEGADERM PER DRAIN, DERMABOND x 2, ABD PADS x 4, Post Op Surgical Bra, Fluffs x 2 pack,

NOTES: EVERYTHING OFF FOOT OF BED (BOVIE, SUCTION, LIGHT SOURCE). Set up for 2 Surgeons/2 separate Bovie Machines

Need to weigh Breasts and write weight down for surgeon

Breasts to Pathology and note to pathology to weigh the breasts.

Bilateral breast reduction