Sign IM Nail and Interlocking Screw System Technique Manual page 42

SURGERY INFORMATION:
Surgery Date (month/day/year):
Surgeon Name(s):
1. Antibiotics Used?
2. Surgery Comments:
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Copy this page for each additional surgery for this patient.
Yes No
If yes:
How long from time of injury? _____ hours _____ days
Name of Antibiotic: ________________________________
Duration of Antibiotic Coverage: _____ hours _____ days
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