Surgical Procedure Review Form-1

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School

Richland Community College *

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Course

245

Subject

Medicine

Date

Dec 6, 2023

Type

pdf

Pages

4

Uploaded by KidStork3633

Report
Name: ___________________ Procedure Name and CDC Classification with Rationale: ________________________________________________________________________ Surgical Procedure Review class l clean : These types of wounds are not infected, do not exhibit any signs of inflammation, and are typically closed. Pathology/Disease/Condition (reasons the patient would need this procedure): A tympanoplasty may be needed to repair a perforated eardrum that does not heal on its own. Adults or children can get a hole in the eardrum from an ear infection, injury, or head trauma. Or to remove middle ear masses and to improve hearing. A. Required diagnostic procedures: Examination of the ear using an otoscope and a microscope to visualize the eardrum. Some hearing screening programs include middle ear impedance testing, or tympanometry. B. Patient position and positioning devices/supplies: supine with head turned to expose operative site- arms tucked at sides with a sheet donut head pillow safety strap C. Skin Prep 1. Solution Used: Povidone-iodine 2. Prepping Parameters: ___1 inch above the ear, down to the ear, stopping at the neck above the collar bone _____________________________________________________________________________ D. Drapes1 turban style head drape is used - clear plastic drape is applied- head/neck drape placed Order of Use : 1.____turban style head drape ________________________________________________________________________________________________
Name: ___________________ Procedure Name and CDC Classification with Rationale: ________________________________________________________________________ 2.__clear plastic drape _________________________________________________________________________________________________ 3.___________head or neck drape _________________________________________________________________________________________ 4. ____________________________________________________________________________________________________ G. Incision Name and Site 1.An incision is made in the ear canal (endaural, lateral circumferential, or swing door) H. Supplies Needed for this Procedure: 1.Sutures:The skin is closed with a running intradermal suture of 1-0 polyglactin 910 (Vicryl) or polyglycolic acid (Dexon) on a cutting needle. 2.Sponges: _____raytecs laps ________________________________________________________________________________________ 3.Bovie Type: __________________________________________________________________________________________ 4.Medications: The postauricular area, canal, and tragus (if necessary) are injected with 1% lidocaine with w epi 5.Ancillary supplies: ossicular implants if needed - gelfoam - bone wax - suture - dressing I. Room Equipment 1.operating microscope sitting stools ear drill if mastoidectomy is planned __________________________________ J. Instrument Trays 1.ear instrument tray
Name: ___________________ Procedure Name and CDC Classification with Rationale: ________________________________________________________________________ 2._______________________________________________________________________ 3._______________________________________________________________________ K. Counts- (Full or Sponges and Sharps) 1. Initial_______sponges and sharps __________________________________________________________________________________________ 2. Closing___________________sponges and sharps _____________________________________________________________________________ L. Dressing Materials 1. _______steri strips ______________________________________________________________________________________________ 2. ______________mastoid dressing _______________________________________________________________________________________ M. Procedural Steps The patient is positioned on the OR table as described earlier. Whether the procedure is performed under local or general anesthesia depends on the extent of the surgery, the surgeon’s preference, and the desire of the patient. After appropriate sedation or induction of anesthesia, the ear and plastic drape are scrubbed with the proper soap or solution. Some surgeons place a cotton ball in the meatus if a perforation exists, preferring not to allow the preparation solution to enter the middle ear. The field is draped as described earlier. The surgeon enters the ear Through an ear speculum, vascular strip incisions are made with the sickle or Robinson knife and united along the annulus with the lancet knife. The vascular strip incisions are completed with a No. 64 or 67 Beaver blade. This same blade can be used to transect the anterior canal skin just medial to the bony-cartilaginous junction. The postauricular incision is made with a No. 15 Bard-Parker blade behind the sulcus.
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Name: ___________________ Procedure Name and CDC Classification with Rationale: ________________________________________________________________________ Continued postauricular exposure is obtained by incising along the linea temporalis with a knife or with the electrocautery. A perpendicular incision is made down to the mastoid tip.The level of the temporalis fascia is identified, and a small self-retaining (Weitlaner) retractor is inserted. After locating the hole in the eardrum with a microscope or endoscope, the surgeon removes the edges of the hole and then closes it with a graft securing it with gel foam Wound closure is accomplished in two layers with absorbable sutures. The skin is closed with a running intradermal suture of 1-0 polyglactin 910 (Vicryl) or polyglycolic acid (Dexon) on a cutting needle. Steri-Strips are applied, and the wound is covered with a standard mastoid dressing. with a ryder needle holder and adson tissue forceps, the suture is cut with mayo scissors.