Procedures Intermediate Format Abdominoplasty

Objectives Assess the related terminology and pathophysiology of the ____________. Analyze the diagnostic interventions for a patient undergoing a _______________. Plan the intraoperative course for a patient undergoing_____________. Assemble supplies, equipment, and instrumentation needed for the procedure.

Objectives Choose the appropriate patient position Identify the incision used for the procedure Analyze the procedural steps for Abdominoplasty. Describe the care of the specimen Also: See Objectives MAVCC Unit 9: OBJ

Terms and Definitions

Definition/Purpose of Procedure Excision of excess fat and abdominal wall skin and tightening of the abdominal musculature Also called Tummy Tuck NOT a surgery for obese patients

Pathophysiology Excess Fat

Surgical Intervention: Special Considerations Patient Factors –Women of child-bearing age should delay this procedure until all pregnancies are complete Room Set-up Etc

Surgical Intervention: Positioning Position during procedure –Supine w/arms abducted 90 degrees on armboards Supplies and equipment Special considerations: high risk areas

Surgical Intervention: Special Considerations/Incision Special considerations –Skin prep: remove pubic hair –Parameters: extend from mid-chest to mid-thighs and the entire width of the patient. –Draping: entire abdomen is outlined with towels and laparotomy sheet placed State/Describe incision –Low transverse down to level of fascia (rectus sheath) and it may extend the entire width of the patient.

Surgical Intervention: Supplies General: ESU pencil w/blade and extension tip, Skin marker, Basin set, magnet needle holder, suction tubing, marking pen Specific –Suture: heavy absorbable for deep fat & may be subcuticular running suture –Blades: # 10 x 4 –Medications on field (name & purpose) –Catheters & Drains: 1 or 2 closed wound drainage systems (Hemovac or Jackson Pratt)

Surgical Intervention: Supplies cont’d Lap sponges Skin staples Dressings: light gauze over umbilicus, pressure dressing over main wound (elastoplast or foam tape), abdominal binder or girdle

Surgical Intervention: Instruments General: Basic Plastic Set or Minor set Specific –2 small deaver retractors –Fiberoptic retractor set, umbilical template (cookie cutter) –Extra crile or kocker clamps for grasping

Surgical Intervention: Equipment General Specific –Fiberoptic headlight and light source –Table Scales to weigh specimen

Abdominoplasty Procedure

Counts Initial: Sharps, sponges, instruments First closing Final closing –Sponges –Sharps –Instruments

Specimen & Care Identified as abdominal tissue (ask) Handled: routine, etc.

Postop Information

Which statement regarding abdominoplasty is NOT true? a.Abdominoplasty is the removal of abdominal fat in the obese b.Abdominoplasty requires an overnight stay for the patient c.Abdominoplasty is often performed in conjunction with liposuction d.Abdominoplasty involves the removal of fat from the lower abdominal area

Which incision is usually employed for an abdominoplasty? a.Midline b.Lower midline c.Low transverse d.McBurney

References STST pp Goldman p

Plastic Surgery Terminology Alloplasty, Debridement, Dermatome, Dermis, Donor Site, Epidermis, Erythema, Graft, Lop Ears, Micrognathia, Microtia, Prognathia, Recipient Site

Purposes of Plastic Surgery To correct congenital anomalies To correct disfigurements due to trauma or disease To improve aesthetic (cosmetic) appearance