The patient was seen in the preoperative holding area where consents were reviewed including risks, benefits and alternatives to the proposed treatment, the H&P was updated, and all questions were invited and answered. The patient was then transferred to the OR and onto the OR table in supine position without any issues. All appropriate monitors were placed and confirmed to be working properly. IV induction of general anesthesia was then performed, followed by nasal endotracheal intubation. The tube was secured by the surgical team after confirming end tidal CO2 and bilateral breath sounds. Lacrilube was placed in the eyes and tegaderms were placed bilterally.

First the patient was then prepped and draped in a sterile fashion. Pre-operative antibiotics were given.  The patient was then prepped with 5% Betadyne paint and draped in standard sterile fashion. Time out was then performed with two patient identifiers and team agreed on procedure, laterality, and correct patient. The left lower extremity was prepped with Chloraprep and draped with sterile linens. The patient was then prepped and draped in the routine sterile fashion. 2g Ancef administered. Time out was then performed with two patient identifiers and team agreed on procedure, laterality, and correct patient

Next attention was tuned to the left lateral thigh for harvest of a split thickness skin graft (approximately __ x __ cm). A dermatome set to 0.018 inch thickness was used to harvest the split thickness skin graft and removed from leg with metzenbaums. Donor site covered with epinephrine soaked gauze. This was then later removed and dressed with adaptic secured w staples and tegaderm. The graft with irrigated with saline and small 3 mm incisions placed in graft to prevent post-operative hematoma or seroma formation. The graft was placed over the left lower extremity donor site and secured to skin edges with interrupted 3-0 chromic gut sutures. The skin graft site was dressed with a negative pressure wound vac device.

‍