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
Pages
4
Uploaded by KidStork3633
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.