CUTTING REMARKS
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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 4
this. Thankfully, since I perform most of my surgeries with the
arthroscope, Band-Aids usually suffice. Some patients feel that if
they don't change the dressing soon after surgery, flesh-eating bacte-
ria will attack. Others take the dressings off and replace them with
everything from masking tape to peat moss. Better safe than sorry:
Leave the dressing on until I see you!
• When can I toss this sling?
I'm a shoulder surgeon, so my patients
leave the OR in a sling. The duration of wear depends on the pro-
cedure. Here is where the confusion arises. Massive cuff repairs
are to leave the sling on for at least 6 weeks. A release of adhe-
sions for a stiff shoulder should dispense with the sling ASAP.
When we give the wrong instruction sheet or inadvertently admin-
ister another doctor's protocol, my gastric juice secretion esca-
lates. Several weeks ago a patient with a massive rotator cuff tear
was told to "move his arm right away." Three Hail Marys and 2
Xanax after I discovered this, I told the patient to chill and stay in
the sling.
• Who changed my pain-med regimen?
I try to keep it simple when it
comes to post-op meds. When well-meaning residents change my
post-op pain med regimen, chaos ensues. One well-intentioned
resident felt that my patients were getting too much acetamino-
phen post-op, so she subtly altered my standard post-op pain fare
… only to generate at least 20 phone calls from the PACU. The
dosages she prescribed had enough narcotic to halt a charging
rhino. The resident also left out one detail: She prescribed the
same dosages for all cases. The 90-pound, 14-year-old, hangnail
excision was getting the same oxycontin dose as the 275-pound
football player who had a hip scope. No wonder so many of my
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