315 BRACHIOPLASTY (Arm Lift) with or without LIPOSUCTION

updated January 2009

 

OPERATIVE TIME: 3-4 hours

USUAL LOCATION: Pres Day Surgery

FREQUENCY: rare, 2-4 per year

ASSISTANT: Yes, Gwen

ICD9 CODE: V50.1Elective Cosmetic

CPT CODE: 15836Arm Lift, 15878Liposuction Arms

 

ANESTHESIA NOTES

GA. Patient supine, consider fluid warmer

Start IV on arm, then change to foot.

IV, pulse oximeter and BP to foot

PATIENT POSITION | SETUP

see diagram

Supine, [2-4] armboards, [1-2] on each side.

Methylene blue tattoo setup.

Foley catheter, Plexi-pulses or Sequentials

Bucks traction set up:

          Molded plastic holders, Kerlix, ABD 4" sterile Ace wraps.

Orthopedic shoulder holder

          attaches to bed, 10lb, 4lb weights

TABLE POSITION

Standard, pillow under knees

ROOM SETUP

All equipment to foot of bed:

          Lipo machine, Bair, Plexipulse, Bovie

 

EQUIPMENT and SPECIALS

Digital scale, flow sheet

Orthopedic shoulder holder and molded plastic mitts

Bucks traction setup

Lower body Baer hugger

[2] light sources

LIPOSUCTION

[OPTIONAL]

Liposuction machine, tubing

[2] pressure bags at head of table for tumescentSolution “A” - 2 liters

PREP

Prep both arms and chest at same time

DRAPING

[2] mayo stand covers, [5] medium sheets, reinforced,

[2] packs sticky drapes, [2] 1000 drapes

CAUTERY

Bovie 30/30 pure with silver tip with Saf-T-Vac

SUCTION

[2] suctions: Saf-T-Vac and Yankauer

 

SOLUTIONS | IRRIGATION

Normal saline [3] liters

NEEDLES | SYRINGES

[2] 20cc syringes, [2] long Quincke 22g spinal needles

LOCAL ANESTHETIC

Solution “C” - 200cc

Mix solution “A” for liposuction

MEDICATIONS

Methylene blue and Sharpie for marking before prep

Bacitracin ointment 2 oz

Ancef 1 gm for anesthesia

 

SETS TO OPEN

Special plastic, lipo cannula set [optional], 4mm and 5mm only

Extra saline basin

INSTRUMENTS USED (ON MAYO STAND)

     FORCEPS

01, 03, long adson brown

     SCISSORS

curved Mayo serrated, str Mayo, str Metz

     NEEDLE HOLDERS

[2] crile-wood, [2] mayo-hagar,

     RETRACTORS

[2] large facelift

     KNIFE | BLADES

[2] No. 10

LIPO CANNULAS [optional]

Hunsdadt infiltration handle and cannulas

Liposuction cannulas , 4mm and 5mm

     OTHER

 

 

STERILE SUPPLIES

[4] marking pens

[2] Asepto syringes

Magnetic pad

SPONGES

[4] laps

NON-STERILE SUPPLIES

[2] pressure bags for tumescent solution

 

 

No

Type

SN

status

SUTURES 

[ 4 ]

2-0 Vicryl CT1

J259

 

hold

[ 4 ]

3-0 Vicryl SH

J416

open

 

[ 4 ]

2-0 Monocryl CT1

Y945

open

 

[ 4 ]

4-0 Monocryl PS2

Y426

open

 

[ 2 ]

3-0 Nylon PS1

1663

 

hold

[ 2 ]

5-0 Vicryl P3

J493

 

hold

[ 4 ]

5-0 Plain P3

686

 

hold

 

 

 

 

 

 

 

DRAINS

[2] 15fr Jackson Pratt drains with connectors and bulbs - HOLD

DRESSINGS

[2] Large Tegaderm 4x10" (1627)

[2] Medium Tegaderm 4x4¾" (1626)

[2] ABD

[2] 6" Ace

[2] 4" Ace

[2] Kerlix

[2] safety pins

 

POSTOPERATIVE

 

NOTES

 

 

COMMENTS

 

DIAGRAM

 

SEE ALSO, SAME AS

 

DATE MODIFIED

August 2007, January 2009




brachioplasty1b.jpg



BRACHIOPLASTY SETUP DIAGRAM