# irrigation and debridement of the tibia



## trose45116 (Aug 10, 2010)

any suggestions on this one for the irrigation and debridement


Status post IM rod of the tibia with delayed union of the tibia, with a draining distal tibial screw site insertion. 


POSTOPERATIVE DIAGNOSIS:   Status post IM rod of the tibia with delayed union of the tibia, with a draining distal tibial screw site insertion. 


PROCEDURE:   Irrigation, debridement, culture, dynamization of right tibial nail, removal of two screws.  

ANESTHESIA:   General.   

ANTIBIOTICS:  Ancef 1 gm. 


COMPLICATIONS:   None.  



INDICATIONS:  This is a 41-year-old white male who comes in following intermedullary fixation with proximal distal locking and tibia fracture.  The most distal screw appeared to have drainage over the last 3 to 4 months, and he has what appears to be delayed union by x-ray.  Prior to surgery, the possible risks and complications were all explained including infection, DVT, pulmonary embolus, and possible need for rod exchange.  He understood this and wished to proceed. 



DESCRIPTION OF PROCEDURE:  The patient was brought to the operating room in the supine position.  General anesthesia was administered.  One gram of Ancef was given preoperatively. The right leg was prepped and draped in sterile fashion. The tourniquet was applied and inflated to a pressure of 350 mmHg.  The distal screw site was then opened and we removed two screws.  The area was copiously irrigated with normal saline.  Irrigation and debridement, and cultures obtained.  Closure was then obtained using 3-0 Vicryl and 4-0 nylon was used for the skin.  A bulky dressing was applied.  The tourniquet was deflated.  The patient was awakened and taken to the recovery room in good condition.


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## maryanneheath (Aug 10, 2010)

Hi there,

According to the AAOS Complete Global Service Data, code 20680, Removal of implant, deep, (buried wire, pin, screw, metal band, nail, rod or plate), includes wound irrigation and debridement of surrounding tissue.

Hope that helps!


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## trose45116 (Aug 12, 2010)

thats what i thought but wanted to make sure. thanks


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