PLISSDE
Position
Landmarks
Incisions
Structures at risk
Superficial Dissection
Deep Dissection
Extension
Surgical approach
Check patient
- check correct procedure
- check side of patient
- pre-op NV assessment
- check skin
- confirm allergies
Place X-ray's on viewing box
- pre-op templating
- check implants
- check cement
- check bone graft / substitutes
- check equipment
- check nursing staff familiar with procedure
Position
- GA / regional / LA
- type of table / radiolucent / hand table
- supine / prone / lateral decubitus
- protect nerves and pressure areas
- preop antibiotics
- IDC insertion
- table supports - bolsters / sandbags
- accessories - tourniquet / II / shavers / fluid pumps
Landmarks
Incisions
- longitudinal / transverse
- position of incision
- length of incision
Structures at risk
- always important to mention early
- i.e. CPN, PIN
Superficial Dissection
- subcutaneous tissue
- deep fascia
- structures encountered / first plane
Deep Dissection
- second plane
Extension
- proximal and distal
Wound closure
- drains
- suture
- LA
- dressings
- splints
Post op
- supervise moving patient off table
- check NV status in recovery
- mobilisation / weight bearing etc