| Vaginoplasty Perioperative ERAS Protocol . |
|---|
| Preoperative |
| Counseling and education regarding hospital stay and postoperative protocol |
| Cefazolin 2 gm (weight-based dosing) |
| Metronidazole 500 mg IV |
| Heparin 5000U SC |
| Postoperative medication regimen |
| Enoxaparin 40 mg SC daily if no concern of bleeding |
| Cefazolin 2 gm IV Q8H for 24 hours |
| Acetaminophen 650 mg PO Q8H |
| Gabapentin 100 mg PO Q8H |
| Ibuprofen 600 mg PO Q6-8H |
| Hydrocodone-acetaminophen 5-325 PO Q6H PRN |
| Senna 17.2 mg PO nightly and docusate sodium PO 100 mg BID |
| Flomax 0.4 mg nightly |
| Postoperative labs |
| Complete blood count, basic metabolic panel, BUN/creatinine, magnesium |
| Recheck only if following abnormal values |
| Hospitalization |
| Diet |
| Clear liquid diet on POD0; Advance to regular diet on POD1 |
| Activity/Mobilization |
| Head of bed elevated at 30 degrees, no sitting upright for 2 weeks |
| Out of bed standing on POD0, ambulate in room |
| Increasing ambulation on POD1 |
| Surgical Site Care |
| Ice packs to labia and perineum every 2 hours for 15 minutes |
| Discharge POD2 |
| Sponge bath only; keep surgical site clean and dry |
| No sitting upright in chair for 2 weeks |
| Ambulate at least 3 times per day |
| Record drain outputs |
| Continue ice packs |
| Follow-up in clinic in 1 week |
| Discharge medication regimen |
| Acetaminophen 650 mg PO Q8H PRN |
| Ibuprofen 600 mg PO Q6H PRN |
| Gabapentin 100 mg PO TID |
| Hydrocodone-acetaminophen PO 5-325 mg Q6H PRN |
| Nitrofurantoin 100 mg daily while catheter in place |
| Colace 100 mg twice a day; hold for loose stools |
| Resume estrogen at 1/2 preoperative dose; discontinue home spironolactone |
| Vaginoplasty Perioperative ERAS Protocol . |
|---|
| Preoperative |
| Counseling and education regarding hospital stay and postoperative protocol |
| Cefazolin 2 gm (weight-based dosing) |
| Metronidazole 500 mg IV |
| Heparin 5000U SC |
| Postoperative medication regimen |
| Enoxaparin 40 mg SC daily if no concern of bleeding |
| Cefazolin 2 gm IV Q8H for 24 hours |
| Acetaminophen 650 mg PO Q8H |
| Gabapentin 100 mg PO Q8H |
| Ibuprofen 600 mg PO Q6-8H |
| Hydrocodone-acetaminophen 5-325 PO Q6H PRN |
| Senna 17.2 mg PO nightly and docusate sodium PO 100 mg BID |
| Flomax 0.4 mg nightly |
| Postoperative labs |
| Complete blood count, basic metabolic panel, BUN/creatinine, magnesium |
| Recheck only if following abnormal values |
| Hospitalization |
| Diet |
| Clear liquid diet on POD0; Advance to regular diet on POD1 |
| Activity/Mobilization |
| Head of bed elevated at 30 degrees, no sitting upright for 2 weeks |
| Out of bed standing on POD0, ambulate in room |
| Increasing ambulation on POD1 |
| Surgical Site Care |
| Ice packs to labia and perineum every 2 hours for 15 minutes |
| Discharge POD2 |
| Sponge bath only; keep surgical site clean and dry |
| No sitting upright in chair for 2 weeks |
| Ambulate at least 3 times per day |
| Record drain outputs |
| Continue ice packs |
| Follow-up in clinic in 1 week |
| Discharge medication regimen |
| Acetaminophen 650 mg PO Q8H PRN |
| Ibuprofen 600 mg PO Q6H PRN |
| Gabapentin 100 mg PO TID |
| Hydrocodone-acetaminophen PO 5-325 mg Q6H PRN |
| Nitrofurantoin 100 mg daily while catheter in place |
| Colace 100 mg twice a day; hold for loose stools |
| Resume estrogen at 1/2 preoperative dose; discontinue home spironolactone |
BID, 2 times a day; BUN, blood urea nitrogen; IV, intravenous; PO, by mouth; POD, postoperative day; PRN, as needed; Q8H, every 8 hours; SC, subcutaneous; TID, 3 times a day.
| Vaginoplasty Perioperative ERAS Protocol . |
|---|
| Preoperative |
| Counseling and education regarding hospital stay and postoperative protocol |
| Cefazolin 2 gm (weight-based dosing) |
| Metronidazole 500 mg IV |
| Heparin 5000U SC |
| Postoperative medication regimen |
| Enoxaparin 40 mg SC daily if no concern of bleeding |
| Cefazolin 2 gm IV Q8H for 24 hours |
| Acetaminophen 650 mg PO Q8H |
| Gabapentin 100 mg PO Q8H |
| Ibuprofen 600 mg PO Q6-8H |
| Hydrocodone-acetaminophen 5-325 PO Q6H PRN |
| Senna 17.2 mg PO nightly and docusate sodium PO 100 mg BID |
| Flomax 0.4 mg nightly |
| Postoperative labs |
| Complete blood count, basic metabolic panel, BUN/creatinine, magnesium |
| Recheck only if following abnormal values |
| Hospitalization |
| Diet |
| Clear liquid diet on POD0; Advance to regular diet on POD1 |
| Activity/Mobilization |
| Head of bed elevated at 30 degrees, no sitting upright for 2 weeks |
| Out of bed standing on POD0, ambulate in room |
| Increasing ambulation on POD1 |
| Surgical Site Care |
| Ice packs to labia and perineum every 2 hours for 15 minutes |
| Discharge POD2 |
| Sponge bath only; keep surgical site clean and dry |
| No sitting upright in chair for 2 weeks |
| Ambulate at least 3 times per day |
| Record drain outputs |
| Continue ice packs |
| Follow-up in clinic in 1 week |
| Discharge medication regimen |
| Acetaminophen 650 mg PO Q8H PRN |
| Ibuprofen 600 mg PO Q6H PRN |
| Gabapentin 100 mg PO TID |
| Hydrocodone-acetaminophen PO 5-325 mg Q6H PRN |
| Nitrofurantoin 100 mg daily while catheter in place |
| Colace 100 mg twice a day; hold for loose stools |
| Resume estrogen at 1/2 preoperative dose; discontinue home spironolactone |
| Vaginoplasty Perioperative ERAS Protocol . |
|---|
| Preoperative |
| Counseling and education regarding hospital stay and postoperative protocol |
| Cefazolin 2 gm (weight-based dosing) |
| Metronidazole 500 mg IV |
| Heparin 5000U SC |
| Postoperative medication regimen |
| Enoxaparin 40 mg SC daily if no concern of bleeding |
| Cefazolin 2 gm IV Q8H for 24 hours |
| Acetaminophen 650 mg PO Q8H |
| Gabapentin 100 mg PO Q8H |
| Ibuprofen 600 mg PO Q6-8H |
| Hydrocodone-acetaminophen 5-325 PO Q6H PRN |
| Senna 17.2 mg PO nightly and docusate sodium PO 100 mg BID |
| Flomax 0.4 mg nightly |
| Postoperative labs |
| Complete blood count, basic metabolic panel, BUN/creatinine, magnesium |
| Recheck only if following abnormal values |
| Hospitalization |
| Diet |
| Clear liquid diet on POD0; Advance to regular diet on POD1 |
| Activity/Mobilization |
| Head of bed elevated at 30 degrees, no sitting upright for 2 weeks |
| Out of bed standing on POD0, ambulate in room |
| Increasing ambulation on POD1 |
| Surgical Site Care |
| Ice packs to labia and perineum every 2 hours for 15 minutes |
| Discharge POD2 |
| Sponge bath only; keep surgical site clean and dry |
| No sitting upright in chair for 2 weeks |
| Ambulate at least 3 times per day |
| Record drain outputs |
| Continue ice packs |
| Follow-up in clinic in 1 week |
| Discharge medication regimen |
| Acetaminophen 650 mg PO Q8H PRN |
| Ibuprofen 600 mg PO Q6H PRN |
| Gabapentin 100 mg PO TID |
| Hydrocodone-acetaminophen PO 5-325 mg Q6H PRN |
| Nitrofurantoin 100 mg daily while catheter in place |
| Colace 100 mg twice a day; hold for loose stools |
| Resume estrogen at 1/2 preoperative dose; discontinue home spironolactone |
BID, 2 times a day; BUN, blood urea nitrogen; IV, intravenous; PO, by mouth; POD, postoperative day; PRN, as needed; Q8H, every 8 hours; SC, subcutaneous; TID, 3 times a day.
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