Case No.: 3 Hospital no: 14- 07-16 Name of Student: Christine Joy A. Ala Year and Section 3NUR1 OR Preference Cards Name of Patient: Tadeo, Linda Vidal Age: 45 Sex: F Civil Status: Married Date of Admission: 11/3/15 Date of Surgery: 11/4/15 TimeStarted/Ended: 9:30AM/11:28AM Bed #: 222G Registration / Receipt #: Surgeon: Dr. Hernandez Assistant Surgeon: Dr. Unas Anesthesiologist: Dra. Siao/Diaz Scrub Nurse: Sarah Jane Palo, RN 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

Wound Suturing - Minor

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Case No.: 3 Hospital no: 14-07-16Name of Student: Christine Joy A. AlaYear and Section 3NUR1

OR Preference Cards

Name of Patient: Tadeo, Linda Vidal Age: 45 Sex: F Civil Status: MarriedDate of Admission: 11/3/15 Date of Surgery: 11/4/15 TimeStarted/Ended: 9:30AM/11:28AMBed #: 222G Registration / Receipt #:

Surgeon: Dr. Hernandez Assistant Surgeon: Dr. Unas Anesthesiologist: Dra. Siao/Diaz

Scrub Nurse: Sarah Jane Palo, RN Circulating Nurse: Aimee, RN

Chief Complaint: Non-healing wound, right parietal areaPatho-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 craniotomyRationale / 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 flapRationale/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: GeneralSpecific Technique: GETAAnesthetic Agent: SevofluraneMechanism 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: SupineIncision: Longhitudinal incision in the scalpSkin Preparation: cutaseptDraping: head to feet