Plastics

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=====Dr. Egan =====

PLEASE DO NOT ORDER BREAST US FOR RECONSTRUCTIVE PATIENTS WITH C/F INFECTION. PERFORM PHYSICAL EXAMINATION, INSTEAD.

DIEP Postop Protocol \\
Pain: Toradol okay in PACU; Lyrica, Oxy, Dilaudid, Tylenol, Celebrex starting POD#1\\
CV: Continuous tele, pulse ox\\
Pulm: IS, wean O2\\
Renal: DC foley immediately postop \\
GI: Regular diet\\
Heme: No ASA, pLov on POD1 (and preop)\\
ID: Ancef x 24 hours \\
MSK: No bedrest, no flexed when walking, no walker. Only activity restriction is no lifting >5-10lbs. \\
Flap checks: Q1h until POD#1, then transition to q2h in afternoon \\

Dressings: 
	- Prevena on abdomen, discharge with it in place. If you have to remove it, put paper tape over incision.
	- Nitro paste + tegaderm on umbilicus: if have to remove, replace with just Vaseline 
	- Breast incisions: Xeroform; discontinue before discharge 
	- Pink bra placed immediately postop
	- No abdominal binder 
	- +/- NAC nitro paste and xeroform if concerning on spy; if concerning, q8h for 24 hours 
Discharge home on POD2