Preoperative Diagnosis:bilateral ruptured silicone implants,fever of unknown origin
Postoperative Diagnosis: same
Procedure Performed: Bilateral removal of ruptured silicone implants. Bilateral capsulectomies
Anesthesia:General
Antibiotics:Vancomycin 1 gm iv, cleocin 900mg IV
Complications: none
IV Fluids: 900ml
Estimated Blood Loss: Minimal
Specimens: bilateral implants, scars and capsule for culture and path
Procedure Findings: Bilateral ruptured implants
Condition of Patient:
The patient was transferred in stable condition.
The patient was transferred to the OR and placed into a supine position. General LMA anesthesia was induced. The patient was prepped and draped. A formal timeout procedure was then performed. Once all members of the operative team were in agreement the procedure commenced.
The right breast was addressed first. The previous incision was excised for a total of 6 cm. The subcutaneous tissues were divided with electrocautery and the capsule was identified. The capsule was carefully dissected circumferentially, releasing the capsule from the surrounding tissues. Once freed, the capsule and implant were removed en bloc from the wound. The wound was then irrigated with antibiotic containing solution and hemostasis was noted. A 15F blake drain was then placed into the wound and brought out at the midaxillary line lateral to the incision. The drain was secured with interrupted 3-0 nylon. The wound was closed with deep, interrupted 3-0 polysorb and deep dermal interrupted 3-0 polysorb and a running 4-0 subcuticular polysorb.
The left breast was then addressed. The previous incision was excised for a total of 6 cm. The subcutaneous tissues were divided with electrocautery and the capsule was identified. The capsule was carefully dissected circumferentially, releasing the capsule from the surrounding tissues. Once freed, the capsule and implant were removed en bloc from the wound. The wound was then irrigated with antibiotic containing solution and hemostasis was noted. A 15F blake drain was then placed into the wound and brought out at the midaxillary line lateral to the incision. The drain was secured with interrupted 3-0 nylon. The wound was closed with deep, interrupted 3-0 polysorb and deep dermal interrupted 3-0 polysorb and a running 4-0 subcuticular polysorb.
Steri-strips were applied to the incision followed by circumferentially placed kerlix and ace wraps. Patient was allowed to awaken from anesthesia and the LMA device was removed. She was then transferred to the PACU in stable condition. The patient tolerated the procedure well, no complications. Count were correct x2.
Postoperative Diagnosis: same
Procedure Performed: Bilateral removal of ruptured silicone implants. Bilateral capsulectomies
Anesthesia:General
Antibiotics:Vancomycin 1 gm iv, cleocin 900mg IV
Complications: none
IV Fluids: 900ml
Estimated Blood Loss: Minimal
Specimens: bilateral implants, scars and capsule for culture and path
Procedure Findings: Bilateral ruptured implants
Condition of Patient:
The patient was transferred in stable condition.
The patient was transferred to the OR and placed into a supine position. General LMA anesthesia was induced. The patient was prepped and draped. A formal timeout procedure was then performed. Once all members of the operative team were in agreement the procedure commenced.
The right breast was addressed first. The previous incision was excised for a total of 6 cm. The subcutaneous tissues were divided with electrocautery and the capsule was identified. The capsule was carefully dissected circumferentially, releasing the capsule from the surrounding tissues. Once freed, the capsule and implant were removed en bloc from the wound. The wound was then irrigated with antibiotic containing solution and hemostasis was noted. A 15F blake drain was then placed into the wound and brought out at the midaxillary line lateral to the incision. The drain was secured with interrupted 3-0 nylon. The wound was closed with deep, interrupted 3-0 polysorb and deep dermal interrupted 3-0 polysorb and a running 4-0 subcuticular polysorb.
The left breast was then addressed. The previous incision was excised for a total of 6 cm. The subcutaneous tissues were divided with electrocautery and the capsule was identified. The capsule was carefully dissected circumferentially, releasing the capsule from the surrounding tissues. Once freed, the capsule and implant were removed en bloc from the wound. The wound was then irrigated with antibiotic containing solution and hemostasis was noted. A 15F blake drain was then placed into the wound and brought out at the midaxillary line lateral to the incision. The drain was secured with interrupted 3-0 nylon. The wound was closed with deep, interrupted 3-0 polysorb and deep dermal interrupted 3-0 polysorb and a running 4-0 subcuticular polysorb.
Steri-strips were applied to the incision followed by circumferentially placed kerlix and ace wraps. Patient was allowed to awaken from anesthesia and the LMA device was removed. She was then transferred to the PACU in stable condition. The patient tolerated the procedure well, no complications. Count were correct x2.