13120 Would you agree ???
The patient's scalp was prepped and draped in standard fashion. Of note, there was a bulging surgical incision with pulsatile bleeding traversing across the incision. There were still surgical sutures in place. The sutures were removed and there was old hematoma within, without evidence of infection. This was evacuated. There was still pulsatile blood flowing from the inferior aspect of the wound, but there is no well-visualized vessel. The edges of the incision were excised and more exposure was therefore available. At this point, an arterial bleeding vessel at the base of the wound was identified and this stopped the hemorrhage once the pressure had been applied. The remainder of the hematoma within the cavity was evacuated and the base of the wound was debrided. The bleeding vessel was oversewn with 2-0 chromic. The remainder of the wound was evaluated and there are no other bleeding lesions. The scalp was then closed in layers using a second 2-0 chromic and then a 3-0 nylon which was placed in a locked running fashion for further hemostasis. Dressings were then applied.
The patient's scalp was prepped and draped in standard fashion. Of note, there was a bulging surgical incision with pulsatile bleeding traversing across the incision. There were still surgical sutures in place. The sutures were removed and there was old hematoma within, without evidence of infection. This was evacuated. There was still pulsatile blood flowing from the inferior aspect of the wound, but there is no well-visualized vessel. The edges of the incision were excised and more exposure was therefore available. At this point, an arterial bleeding vessel at the base of the wound was identified and this stopped the hemorrhage once the pressure had been applied. The remainder of the hematoma within the cavity was evacuated and the base of the wound was debrided. The bleeding vessel was oversewn with 2-0 chromic. The remainder of the wound was evaluated and there are no other bleeding lesions. The scalp was then closed in layers using a second 2-0 chromic and then a 3-0 nylon which was placed in a locked running fashion for further hemostasis. Dressings were then applied.