Plastics

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:

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

Discharge home on POD2