Nursing Instructions
Fusiform Excision
Nonsterile Tray for Anesthesia and Designing the Fusiform Excision
Place the following items on a nonsterile drape covering a Mayo stand:
Nonsterile gloves and mask
Skin marking pen
4 X 4 gauze
Povidone-iodine solution
10-mL syringe filled with 1 or 2 percent lidocaine (Xylocaine) with or without epinephrine with a 30-gauge needle
Sterile Tray for the Procedure
Place the following items on a sterile drape covering a Mayo stand:
Sterile gloves
Fenestrated disposable drape
Additional nonfenestrated disposable drape (if desired)
2 sterile bandages to anchor the fenestrated drape
3 hemostats (mosquito clamps)
No. 15 scalpel blade and handle
Needle holder
Mayo or tissue scissors
Iris scissors for cutting sutures
Adson forceps
21-gauge, 1 1/2-inch needle (to be bent into a skin hook)
2 inches of 4 X 4 gauze
Suture materials
Postprocedure Nursing Instructions
The patient or an assistant should apply direct pressure to the surgical site with gauze for 10 minutes following the procedure. After this pressure has been applied, the skin can be cleaned with water or sterile saline. The wound can be squeezed to remove any residual blood from beneath the wound.
Antibiotic ointment, one-half inch of gauze, and elastic bandage are applied over the clean wound. Tape should be placed around the outer edges of the elastic bandage to keep the edges from curling off the skin. The pressure bandage can be worn until the morning following the procedure.
All instruments should be scrubbed, washed, rinsed, and dried. The instruments are then placed in clear sterilization pouches, individually or as a surgical tray, and sterilized in the autoclave.
Sharps (scalpel blade, needles, suture needles) are disposed of in an appropriate sharps container.
The bloody gauze is disposed of in a biohazard waste container.
The pathology specimen is appropriately labeled and sent for evaluation.
Adapted with permission from Zuber TJ. Office procedures. Baltimore: Lippincott Williams & Wilkins, 1999.
Copyright © 2003 by the American Academy of
Family Physicians.
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