3. PREPARATION
1. Greet patients respectfully
2. Check medical record and assess the indication for
implant insertion
3. Explain the procedures and ask if clients have some
questions
4. Ask clients if they have history of allergy to antiseptics
and local anaesthetics
15. if the gloves are covered with powder, clean it by soaking in
sterile water or DTT
16. 10. Make sure sterile instruments and DTT are already
prepared
17. 4. Prepare area of insertion with antiseptic solution, swab
from central to peripheral about 8-12 cm range. Then, let
it dry
18. 5. Put on sterile linen or DTT around client’s hand
6. Explain to client that she will be injected with local
anaesthesia so that she may feel a little pain
19. 6. Inject 0,3 -0,5 cc of 1% local anaesthesia 1% (without
epinephrine) subcutaneously right at the incision area.
20. 8. Continue the subcutaneous injection for about 5 cm and
inject 1 cc of local anaesthesia while pulling out the
needle gently.
21. 9. Remove the needle and place it in safe place to avoid
accident
22. 10. Gently push injection area to spread the anaesthesia
well.
23. 11. Touch the injected area with scalpel to know if the
anaesthesia is already working. If client still complaints
pain, wait for about 2 minutes and reassess the
anaesthesia effect.
24. INSERTION
1. Make shallow incision about 2 mm wide with scalpel
(alternatively, we can also directly penetrate the trocar
to subdermal area without incision)
25. On the trocar there are three marks
1 : Mark for inserting
trocar to subdermis
for Sinoplant
2 : Mark for inserting trocar to
subdermis for Norplant
3 : Mark for trocar tip that remains in subdermis after first
rod insertion
INDOPLANT
SINOPLANT
NORPLANT
26. 2. Insert trocar and inserter through incised area in narrow
angle
27. 3. While lifting the inserted trocar, push the trocar until first
mark is at the incised area
28.
29. 4. Pull out the inserter
5. Insert first rod to the trocar by hand
30. Or insert the rod to trocar with pinset, open the other hand
below to catch the rod if it falls.
41. 3. Put sterile bandage on insertion area to avoid bleeding
and swelling.
42. 4. Soak trocar, inserter and needle in 0.5%-chlorin 3X
before removal.
43. 5. Before putting-off the gloves,
place all instruments and gloves in
0.5% chlorin solution to prevent
contamination
6. Carefully remove all materials as
medical waste.
7. Put off gloves carefully
44. Care for insertion area
● Keep it clean and dry for at least 48 hours
incision wound may get infected if it is wet
● bandage removal can be performed after 48 hours
Elastic bandage can be removed after 3 - 5 days
● discoloration and edema are possible to be found and
considered as normal findings during few days after
insertion.
45. ● client can do their daily activites as usual but needs to
avoid heavy lifting or bumps.
● insertion and incision area can be touched when incision
wound is fully healed.
● visit the doctor immediately when pus is found