Voorbereiding ingreep

Peri-operative care

Key points
Peri-operative management of oral and maxillofacial surgery is optimized by familiarity with established protocols and use of surgical safety checklists
Since implant placement is an elective surgery, contraindications should be thoroughly evaluated and balanced versus the benefit of treatment

Preoperative evaluation
As described in Patient Assessment, a thorough evaluation of patient factors influencing whether to proceed with surgical therapy is relevant. Depending on the tpe of surgery prescribe pre-operative medication (for example antibiotic coverage), if applicable.

Peri-operative measures immediately prior to surgery
The following list describes important steps to be followed to inform the patient and prepare them properly for imminent surgery:

1. Brief information about procedure to ensure that the patient understands and can ask questions about the surgical procedures
2. Short acting benzodiazepine can be useful for ambulatory surgery
3. If conscious sedation is provided, ensure that an accompanying, responsible adult person will be present with the patient for approx. 3 hours after surgery
4. Disinfection of the operative field
5. Preferrably cover patient’s nose with a perforated cap to allow for easy breathing and cover face and body with sterile drapes to limit/avoid use of antibiotics
6. Use appropriate surgical safety checklist (http://www.for.org/checklists)

Peri-operative care during surgery
The following list describes the important steps to be followed while surgery is being performed:

1. Gentle conversations and smooth movements improve patient’s confidence and comfort
2. Avoid external pathogens especially from nose by ensuring that the entire team wears masks properly
3. The entire surgical team should be trained in asepsis
4. If conscious sedation is being provided, the patient's vital signs should be continuously monitored
5. If the patient panics, remove surgical fields and interrupt the surgery
6. Use appropriate surgical safety checklist (http://www.for.org/checklists)