Case No.

: 3
Name of Student: Christine Joy A. Ala
Year and Section 3NUR1

Hospital no: 14-07-16

OR Preference Cards

Name of Patient: Tadeo, Linda Vidal

Age: 45
Date of Admission: 11/3/15
Date of Surgery: 11/4/15
Bed #: 222G
Registration / Receipt #:
Surgeon: Dr. Hernandez

Sex: F
Civil Status: Married
TimeStarted/Ended: 9:30AM/11:28AM

Assistant Surgeon: Dr. Unas

Scrub Nurse: Sarah Jane Palo, RN

Anesthesiologist: Dra. Siao/Diaz

Circulating Nurse: Aimee, RN

Chief Complaint: Non-healing wound, right parietal area

Patho-physiology: Wound healing occurs as a cellular response to tissue injury and involves activation of
keratinocytes, fibroblasts, endothelial cells, macrophages, and platelets. The process involves organized
cell migration and recruitment o fendothelial cells for angiogenesis. Many growth factors and cytokines
released by these cell types coordinate and maintain wound healing. Chronic wounds are arrested in one
of these stages, usually the inflammatory stage, and cannot progress further.
Rationale / Definition: A non-healing or chronic wound is defined as a wound that does not improve after
four weeks or does not heal in eight weeks.

Post Operative Diagnosis: exposed cranial non-healing wound s/o craniotomy

Rationale / Definition: Reconstruction of the scalp after one of the above procedures may include any of
the following techniques: granulation; side-to-side closure; the use of an advancement flap, rotation flap,
or transposition flap; or the use of a split-thickness skin graft (STSG) or full-thickness skin graft (FTSG).
Complete Surgical Procedure: Wound suturing scalp/scalp rotational flap
Rationale/Definition: Scalp surgery is performed on an increasingly frequent basis. This article
emphasizes scalp surgery and reconstruction as they pertain to dermatologic surgery and surgery
performed by primary care physicians.
Indication: Common procedures performed on the scalp range from those that are medically indicated to
those performed for cosmetic reasons. These procedures include incisional and excisional biopsies,
excisions of benign and malignant tumors, and scalp reduction surgery.
Type of Anesthesia: General
Specific Technique: GETA
Anesthetic Agent: Sevoflurane
Mechanism of Action: induces a reduction In junctional conductance by decreasing gap junction channel
opening times and increasing gap junction channel closing times. It also activates calcium dependent
ATPase in the sarcoplasmic reticulum y increasing the fluidity of the lipid membrane.

Position: Supine
Incision: Longhitudinal incision in the scalp
Skin Preparation: cutasept
Draping: head to feet

Instruments used:
Cutting
Grasping
Mayo straight
Metz
blade

Tissue forceps
Thumb forceps
Adson

Sutures and Needles:

Tissue Layer
SKIN
Subcutaneous

Other Supplies Used:

Retracting

Clamping

Others:

Army navy

Allis
Needle holder
Mosquito curve
Mosquito straight
Towel clip
Kelly
parabeua

24s gauze
Kidney basin
Bowl
Med cup

Suture Used
Prolene 3-o
Monocryl 2o

Needle
Taper
Taper
Taper
taper

Suturing Technique
Discontinuous
Discontinuous
Discontinuous
Discontinuous