Blepharoplasty
Exploratory/Artery Repair
Exploratory/Artery Repair involves surgically opening the area to examine and repair damaged arteries to restore proper blood flow and prevent complications.
01 - Patient Setup
Pre-op Meds: None specified
Anesthesia: General
Patient Position: Supine.
Bed Position: No turn
DVT Prophylaxis: None specified
Side Table: N/A
Lights: Overhead only
Power: None specified
Bovie Settings: None specified
Preinjection: None specified
Prep: See Patient Position
Drapes: Universal
Instrument Sets: Red microsurgery cart, pink plastic surgery cart​​​​​
02 - Case Details
Special Instruments: Special equipment–bipolar, lead hand, Mitaka microscope, fluid warmer, heparinized saline (must be kept in the warmer, can be made with 10,000 units of heparin in 100 cc of injectable normal saline for final concentration of 100 units/cc), Koven doppler on the field, 21-gauge Angiocath, anterior chamber needle, Weck-Cel, neuropatty, fishhook/lonestar.
*The remaining special equipment can be opened on an as-needed basis (coupler, background, vessel loop, etc., these are all found in the red microsurgery cart)*
Devices/Implants: N/A
Hypodermic needles: N/A
Syringes: 21 guage on 20mL syringe
Drains: 2 #15 Blake Drains
Suture: 8-0 nylon, 3-0 nylon, 3-0 chromic SH
*Remaining sutures should be on the plastic surgery cart as there may be concomitant tendon injuries that need to be repaired*
Anesthesia on field: None
Dressing: Prineo
03 - Post-Op Information
Admission status: Same Day Surgery
Estimated time: 3 hrs
Coding: 19318-50, 611.1, 724.2, 724.4
Post-op wound care: Drains out AM prior to D/C
Post-op activity restrictions: No heavy activity for 24 wks
Follow up: 1 wk
Post-Op Instructions obtain from MedConnect
04 - HY Tips
For an upper extremity vascular injury requiring both microsurgery and exploration, ensure to have a microsurgical set along with a minor hand and foot set.
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Tips for Setup:
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Use a hand table, preferably with a kickstand for microsurgery.
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Rotate the bed 90 degrees for optimal access.
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Place an 18-inch tourniquet on the upper arm; use a sterile tourniquet if the arm will be prepped up to the axilla for vein or nerve graft harvest.
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Ensure the microscope is plugged in, functioning, and the eyepieces are properly adjusted.