Midface Fracture


Pre-op Meds: Ancef or clindamycin, 8 mg Decadron

Anesthesia:  general, hypotensive

Patient position: supine

Bed position: 90° surgeon away from anesthesia machine on the patient's right side

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

Side Table: local anesthesia, alcohol wipe, large gloves, 4x4s, Scleral shild(s), Erythromycin ointment

IF THERE IS AN OCCLUSAL INJURY WILL ALSO NEED:  xeroform strip gauze, 2-0 prolene,  scissors, forceps to suture in nasal RAE

Preinjection: inject 10 mL lidocaine 1% 1/100 K epinephrine into each side

Lights:  surgeon headlamp

Power:  yes, drill

Bovie Settings: start with 10/10 & colorado tip, have gaurded teflon tip on field for intra-oral approaches

Prep: Betadine on the face, chlorhexidine in the mouth

Drapes: head draped as shown in illustration, four towels around face, and  a split sheet


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Instrument sets:  Stryker midface set, Carrol-Girrard Screw

IF THERE IS OCCLUSAL INJURY WILL ALSO NEED:  Stryker SmartLock MMF, 24G wire, 26G wire (scrub tech please pre-stretch the wires)


IMG 0177

Special Instruments:  clear plastic self retaining lip retractor

Devices/Implants: Stryker midface set

Hypodermic needles:  27gauge

Syringes: 10 mL

Drains: no

Suture: 3-0 chromic SH, 5-0 PDS taper, 6-0 Fast

Anesthesia on field:  1% lidocaine with 1/100 K epinephrine

Dressing: erythromycin ophthalmic ointment

Admission status: a.m. admission

Estimated time: two hours

Coding: check w surgeon

Post-op wound care:

Post-op activity restirctions:

Follow up: one week

©2013 STEPHEN B. BAKER, MD, DDS, FACS