801 EXCISION LESION OF FACE OR SCALP - PEDIATRIC PAGE 1

includes brow cysts, ear tags, moles, lesions and other minor procedures on children

see also 208 Minor Revision Cleft Lip UPDATED October 5, 2010

 

OPERATIVE TIME: 30-60 minutes

USUAL LOCATION(S): ASC, Pres DSC

FREQUENCY: 10-12/year

ASSISTANT: No

ICD9 CODE:

216.3 Lesion of skin FACE,NS

215.0 tumor HEAD, FACE, NECK

CPT CODE(S):

11440 EXC BENIGN LES FACE/EARS/NOSE/LIPS <.5

11441 EXC BENIGN LES FACE/EARS/NOSE/LIPS 6-10

11442 EXC BENIGN LES FACE/EARS/NOSE/LIPS 11-20

13131 COMPLEX REPAIR FACE/HAND, 1-2.5 CM

13132 COMPLEX REPAIR FACE/HAND, 2.6-7.5 CM

13151 COMPLEX REPAIR eyelids, nose, ears and/or lips < 1 CM

21555 EXC TUMOR SCALP/FACE/NECK/CHEST SUBCUT

21556 EXC TUMOR SCALP/FACE/NECK/CHEST DEEP

 

ANESTHESIA NOTES

General with regular tube or mask, Dr. C to start IV in OR

PATIENT POSITION | SETUP

• Will turn bed 135° - 180°

• Dr. C to suture tube with 3-0 silk SH, needle holder, scissors [HOLD]

• Rolled terrycloth towel

• large round gel doughnut

• Pedi Baer hugger

TABLE POSITION

Lower foot, close head gap, large round gel doughnut, place Baer after turning

ROOM SETUP

Pre-warm room and bed, warm bed w/ Baer

 

EQUIPMENT

Light source w/headlight, Baer hugger

SPECIALS

none

PREP

Technicare with minimal water, cotton tip applicators to clean nose, wipe inside mouth, lightly over eyelids as needed

DRAPING

Head sheet (two green towels and a 3/4 sheet), 3/4 sheet, magnetic pad, rigid box for bovie, towel clips, ½ “ steri-strip for eyes, 1000 drape, 2" Kling pharyngeal pack (hold)

CAUTERY

Bovie 8/8 pure, Colorado needle tip

SUCTION

Always, single with 7fr Frazier tip

 

SOLUTIONS | IRRIGATION

Saline with blue bulb

NEEDLES | SYRINGES

[1-2] 3cc syringe, [1-2] 30g needle 5/8"

LOCAL ANESTHETIC

1% lidocaine w/ epi 1:100,000

MEDICATIONS

Bacitracin ointment

801 EXCISION LESION OF FACE OR SCALP - PEDIATRIC PAGE 2

UPDATED October 5, 2010

 

SETS TO OPEN

Fine Plastic

INSTRUMENTS USED (ON MAYO STAND)

     FORCEPS

05 Adson, .3 & .5 CV fine

     SCISSORS

ribbon tenotomy: Baby-Mama-Papa; str iris, Gradle

     NEEDLE HOLDERS

Castroviejo, smooth Webster

     RETRACTORS

2, 5, 10mm skin hooks, Ragnell

     KNIFE | BLADES

[1-2] 15 BP scalpel blades

     OTHER

 

 

STERILE SUPPLIES

• [2] fine marking pens with ruler

• bacitracin ointment [HOLD]

• ½" steri-strips for eyes [HOLD]

• Dermabond - [HOLD]

SPONGES

Raytec

NON-STERILE SUPPLIES

 

 

 

No

Type

SN

status

SUTURES

[ 1-2 ]

5-0 Chromic P -3

687

 

HOLD

[ 1-2 ]

6-0 Chromic G -1

790

 

HOLD

[ 1-2 ]

5-0 Monocryl P-3

Y493

 

HOLD

[ 1-2 ]

6-0 Monocryl P-1

Y489

 

HOLD

[ 1-2 ]

6-0 Vicryl P-1

J 489

 

HOLD

[ 1-2 ]

6-0 Nylon P-1

697

 

HOLD

[ 1-2 ]

6-0 Prolene P-1

8697

 

HOLD

[ 1-2 ]

6-0 Fast gut PC-1

1916

 

HOLD

[ 1 ]

Dermabond

DHV12

 

HOLD

 

DRAINS

None

DRESSINGS

Bacitracin ointment

Adaptic

4x4

Dermabond

Tegaderm

[HOLD]

[HOLD]

[HOLD]

[HOLD]

[HOLD]

 

POSTOPERATIVE

 

NOTES

 

 

COMMENTS

 

DATE MODIFIED

July 2009, Oct 2010