Free Flap Upper Extremity


 

  Dr. Han Free Flap Upper Extremity  

 

GLOVES:   6.5 Micro Indicator/6.5 Micro  

 

Anesthesia:   General or by Choice. 3000-5000 units IV Heparin on stand-by

 

PREP:   Hibiclens

 

POSITION:   SUPINE, OR Bed, Regular Hand Table, Tourniquet with “10 x 10” around Tourniquet, Extremity Drape, Sitting Stools. Ask-May need to drape another extremity for donor sites, Foley (ask). Extra Tourniquet for Thigh for lower extremity flap.

 

MEDICATIONS: 0.9% NACL IRRIGATION

Heparin Solution 5000 units in 500 ml 0.9 NS

Warm Irrigation or Fluid Warmer

3% Papaverine Undiluted (hold)

Mineral Oil (If doing Skin Graft)

 

INSTRUMENTS: Plastic Surgery Soft Tissue Tray (Curved Littler Scissors, Curved Tenotomy Scissors, Fine Adson Pickup with Teeth), Lead Hand or Tupper Hand Retractor, Hand Kit (Smooth Jacobson Forceps or McCabe Facial Nerve Dissector, Freer Elevator, Cottle Elevator, Baby Mixter Right Angle), Adson-Beckman Retractors, Rakes 6-Prone, Large Gelpis (For Big muscle flap such as Latissimus or Gracilis Flap or Anterolateral Thigh (ALT), Ortho Tray/Debridement Tray

 

EQUIPMENT:   Bipolar, Tourniquet, Fine Adson Bovie, Micro-Instruments and GEM Micro Clip Applier and Clips Cartridges, Microvascular Clip (Acland Bulldog) Tray, Microscope Available Outside (Leica or Zeiss). Zimmer Dermatome/Blade/Mesher/Carrier (Do Not Open), GEM Coupler Device/Couplers Available (Do Not Open), SharpPoint Nerve Stimulator (Do not Open). Cook Implantable Doppler (Hold)

 

SUPPLIES:  

HALF SHEET

Tongue Depressor

Suction

Extremity Drape

Ray-Tech

Surgical Towels

Doppler, Pencil, and Gel

Microsurgical Wipes

LIGHT HANDLE COVER

15 BLADE (3)

#6900 Beaver Blade

10CC SYRINGE (1)

25 GAUGE HYPO (1)

30G Anterior Chamber Irrigation Cannula

Lone Star Elastic Retractors

BASIN FOR NACL (1)

BIPOLAR CORD

TOURNIQUET 18”

4” ESMARK (OPEN, STERILE)

4” WEBRIL (UNDER TOURNIQUET)

CLIP APPLIER 106781 MULTI SMALL

CLIP APPLIER 106781 MULTI Medium

VESSEL LOOPS MINI

Neurosurgial Patties 1/2” x 1”

Cellulose Eye Spears

Microsurgical Background

Drains: 10 mm Flap JP Drain

SUTURES: Ask. 8.0 Ethilon BV 130-4 4-0, and 9.0 Ethilon BV-130-4 Chromatic, 4-0 and 5-0 NYLON and 3-0 Monocryl. 2-0 PDS.

DRESSINGS:   ADAPTIC, WET 4X4, DRY 4X4, 4" WEBRIL or 4" Cast Paddings, 4" PLASTER, 3"/4" ACE WRAP, SLING (IF BLOCKED), Jones Cotton (A roll of Cotton)

 

NOTES: Ask. May need Axogen Products (Nerve Allograft). Tisseel Fibrin Glue. Set up for 2 Surgeons if 2 Surgeons are available (2 Bovie Machines to allow 1 bipolar and 1 bovie functionating independently for each surgeon)

 

LAST UPDATED:  8/27/2018

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