DATE AND TIME: [Date and time]
URGENCY: Elective / Non-elective
SURGEON: [Name]
ASSISTANT: [Name / None]
ANAESTHETIST: [Name]
OPERATION: Femoral-Popliteal Bypass (Above Knee)
ANAESTHETIC: General / spinal anaesthesia
ANTIBIOTICS: IV antibiotics at induction if prosthetic graft
DVT PROPHYLAXIS: [Agent / mechanical / Not indicated]
POSITION: Supine. Leg prepared circumferentially from groin to foot.
INDICATION:
Critical limb ischaemia / severe claudication. Preoperative duplex / CT angiography: superficial femoral artery occlusion, patent above-knee popliteal artery suitable for distal anastomosis. [Long saphenous vein / synthetic PTFE / Dacron graft planned].
INCISION: [Describe incision]