POSITIONING:
Supine, operative arm on Parker table; If gracilis autograft, secure non-operative leg
EQUIPMENT:
Bovie 20/20
Bipolar 12
Bair hugger to lower body
TOURNIQUET:
Arm – 18” with 4” webril and clear 1010 (as high as possible on the arm)
Gracilis autograft – 30” with 6” webril and clear 1015
MEDICATIONS:
Clindamicin 600 mg in 500 ml NS
Decadron 10 mg (to anesthesia)
If doing gracilis autograft🡪 LTA Kit: 4% Lidocaine (4 mL) (https://aam.ucsf.edu/article/topical-airway-anesthesia-devices)
SPLINT:
5×30 Plaster, 15 sheets open, 5 sheets folded, sling
PREP:
Cover operative site with a lap pre-soaked in 3% hydrogen peroxide for 7 minutes
Chloraprep x2
DRAPING:
¾ sheet x2 – one covering chest to feet, one oriented chest to head
Blue towel around the arm just distal to clear 1015 secured with an allis clamp
Stockinette to the mid-forearm
Hand drapes
Coband around stockinette – keeping thumb out and hand flat
**Additional chloraprep to apply after final draping completed
SUPPLIES
Drapes
- Hand pack
- Table drape
- 1010 drape
- X-long gown
- Pack of Towels (x2)
- Ortho linen pack
Blades/Needles
- 18G spinal needle
- 10 Blade
- 15 Blade (x4)
Peel Pack
- Drill and batteries (x2)
- Bipolar forceps
- 2.4 mm guide pin
Sutures
- #1 Ethibond (x3)
- 0 Vicryl CT-2 (x3)
- 2-0 Vicryl CT-2 (x2)
- 3-0 Vicryl CT-2 (x4)
- 2-0 Prolene FS
- 0 FiberWire T-4 (x3)
- If repair
- Arthrex SutureTape (x1)
- Arthrex TigerLoop (x1) and FiberLoop (x1)
- Small cutting free needle
- Large free needle
Instruments
- Arthrex Elbow UCL Reconstruction Tray
- If a repair
- Arthrex UCL repair kit with Internal Brace
Implants
- 2.6 mm Arthrex biceps button (Available)
Dressings
- Steri strips (x3)
- 4×4
- Xeroform
- ABD (x3)
- 4” Bias (x2)
- 4” Webril (1 for tourniquet)
- 1” cloth tape, splint, sling
Contralateral Palmaris
Supplies
- Chloraprep (x2)
- Small chloroprep
- Hydrogen peroxide
- 4” Coban
- 4” Esmark
Drapes
- Extremity sheet
- Medium sheet
- Impervious stockinette
- Mayo stand cover
Sutures
- 3-0 Vicryl CT-2
- 3-0 Nylon PS-2 (x2)
Dressings
- 4” Bias (x2)
Gracilis Autograft
Supplies
- Chloraprep (x2)
- Small chloraprep
- Hydrogen peroxide
- LTA kit
- 4” coban
- ¼ Penrose
- 6” Esmark
Drapes
- Extremity sheet
- Medium sheet
- Impervious stockinette
- Mayo stand cover
- Impervious U drape
Peel Pack
- Tendon stripper (hook)
Sutures
- 2-0 Prolene FS-1
- 2-0 Vicryl CT-2
- 3-0 Vicryl CT-2
Dressings (To Pull)
- ABD (x2)
- 6” bias (x2)
- Long ace wrap
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