1 315 brachioplasty ( arm lift ) with or without LIPOSUCTION. updated January 2009. OPERATIVE TIME: 3-4 hours USUAL LOCATION: Pres Day Surgery FREQUENCY: rare, 2-4 per year ASSISTANT: Yes, Gwen ICD9 CODE: Elective Cosmetic CPT CODE: 15836 arm lift , 15878 Liposuction Arms ANESTHESIA NOTES GA. Patient supine, consider fluid warm er Start IV on arm , then change to foot. IV, pulse oxim eter and BP to foot PATIENT POSITION | SETUP Supine, [2-4] arm boards, [1-2] on each side. see diagram Methylene blue tattoo setup. Foley catheter, Plexi-pulses or Sequentials Bucks traction set up: Molded plastic holders, Kerlix, ABD 4" sterile Ace wraps. Orthopedic shoulder holder attaches to bed, 10lb, 4lb weights TABLE POSITION Standard, pillow under knees ROOM SETUP All equipm ent to foot of bed.
2 Lipo m achine, Bair, Plexipulse, Bovie EQUIPM ENT and SPECIALS Digital scale, flow sheet Orthopedic shoulder holder and m olded plastic m itts Bucks traction setup Lower body Baer hugger  light sources LIPOSUCTION Liposuction m achine, tubing [OPTIONAL]  pressure bags at head of table for tum escent Solution A - 2 liters PREP Prep both arm s and chest at sam e tim e DRAPING  m ayo stand covers,  m edium sheets, reinforced,  packs sticky drapes,  1000 drapes CAUTERY Bovie 30/30 pure with silver tip with Saf-T-Vac SUCTION  suctions: Saf-T-Vac and Yankauer SOLUTIONS | IRRIGATION Norm al saline  liters NEEDLES | SYRINGES  20cc syringes,  long Quincke 22g spinal needles LOCAL ANESTHETIC Solution C - 200cc Mix solution A for liposuction M EDICATIONS Methylene blue and Sharpie for m arking before prep Bacitracin ointm ent 2 oz Ancef 1 gm for anesthesia SETS TO OPEN Special plastic, lipo cannula set [optional], 4m m and 5m m only Extra saline basin INSTRUMENTS USED (ON M AYO STAND).
3 O FORCEPS 01, 03, long adson brown O SCISSORS curved Mayo serrated, str Mayo, str Metz O NEEDLE HOLDERS  crile-wood,  m ayo-hagar, O RETRACTORS  large facelift O KNIFE | BLADES  No. 10. O LIPO CANNULAS [optional] Hunsdadt infiltration handle and cannulas Liposuction cannulas , 4m m and 5m m O OTHER. STERILE SUPPLIES  m arking pens  Asepto syringes Magnetic pad SPONGES  laps NON-STERILE SUPPLIES  pressure bags for tum escent solution No Type SN status SUTURES M  2-0 Vicryl CT1 J259 hold M  3-0 Vicryl SH J416 open M  2-0 Monocryl CT1 Y945 open M  4-0 Monocryl PS2 Y426 open M  3-0 Nylon PS1 1663 hold M  5-0 Vicryl P3 J493 hold M  5-0 Plain P3 686 hold DRAINS  15fr Jackson Pratt drains with connectors and bulbs - HOLD.
4 DRESSINGS  Large Tegaderm 4x10" (1627).  Medium Tegaderm 4x4 " (1626).  ABD.  6" Ace  4" Ace  Kerlix  safety pins POSTOPERATIVE. NOTES. COMMENTS. DIAGRAM. SEE ALSO, SAME AS. DATE MODIFIED August 2007, January 2009. BRACHIOPLASTY SETUP DIAGRAM.