Cleft alveolar bone graft

Pre-op Meds: Ancef or clindamycin

Anesthesia:  general, midline oral RAE  tube


Patient position: supine, hip roll, neck roll



Bed position: 90°

DVT ppx:  compression boots on and working BEFORE induction of anesthesia

Side Table: hip bone graft table to remain sterile and separate from facial table


Lights: surgical headlamp for faith

Power: none

Bovie Settings: two bovies,  one for face and one for hip.

Preinjection: Inject hip prior to prepping with 1% lidocaine 1/100 K  epinephrine.  27gauge needle on a 10 mL syringe

Prep: chloraprep on the hip, Betadine on the face

Drapes: four towels around hip stapled.   Four towels around face and of split sheet with a hole cut out for the hip.

Instrument sets: Cleft palate instrument set

Special Instruments:#9 periosteal elevator,  Castroviejo  forceps.

Devices/Implants: None

Hypodermic needles: 27gauge

Syringes: 10 mL syringe x2.  One for face and one for hip

Drains: none

Suture:  Face: 5-0  vicryl on P2 needle, 4-0 vicry RB1, 4-0 chromic RB-1. Hip: 0 vicryl on a CT1 needle, 3-0 monocryl on RB1 and 4-0 monocryl on  cutting needle.

Anesthesia on field: 10 mL lidocaine epinephrine on a 27gauge needle and a 10 mL syringe for injection into the face

Dressing: Hip dressing: Steri-Strips, Telfa,  and Tegaderm

Admission status: a.m. admission

Estimated time: 90 minutes

Coding: ICD-9 is 526.89, 749.12, 749.00

Post-op wound care: avoid water submersion to hip for 10 days. Full liquid diet for two weeks.

Post-op activity restirctions: Light activity as tolerated

Follow up: two weeks