PREOPERATIVE DIAGNOSIS: Deep burn, right foot.
POSTOPERATIVE DIAGNOSIS: Deep burn, right foot.
PROCEDURE:
1. A 150 cm2 split-thickness skin graft, right foot.
2. Tangential incision of burn eschar, right foot, with 150 cm2.
FINDINGS: Deep partial-thickness burn that would take too long to heal. It was
starting to show some signs of healing, but would probably take several weeks
and have risk of infection and scarring. Decision has been made to proceed with
grafting.
INDICATION FOR OPERATION: Burn as above.
DESCRIPTION OF PROCEDURE: The patient was taken to the operating room where
general anesthesia was induced. Her right foot and thigh were sterilely prepped
and draped.
A Goulian knife with an 8 guard was readied and the burn was excised with the
knife after the tourniquet was inflated to 275. Once I was satisfied that I got
fresh wound bed for grafting, I covered it with epinephrine and saline soaked
sponges and turned to the right thigh. An appropriate sized piece of skin was
taken with the dermatome set at 12 thousandths. The skin was then returned to
the foot, and after hemostasis was obtained with local anesthetic injection
containing epinephrine in both the donor site and the foot, the skin graft was
lain down over the defect and sutured in place with running 5-0 Monocryl suture
around the edge and some interrupted in the middle. It was pie crusted in
scattered areas for drainage. Hemostasis was good at the end. It was covered
with Xeroform and wound VAC. The donor site was dressed with an OpSite. The
patient was then awakened, extubated, and taken to the recovery room in stable
condition. The entire procedure was well tolerated.
What I was thinking:
15120
15121
15004
15005
POSTOPERATIVE DIAGNOSIS: Deep burn, right foot.
PROCEDURE:
1. A 150 cm2 split-thickness skin graft, right foot.
2. Tangential incision of burn eschar, right foot, with 150 cm2.
FINDINGS: Deep partial-thickness burn that would take too long to heal. It was
starting to show some signs of healing, but would probably take several weeks
and have risk of infection and scarring. Decision has been made to proceed with
grafting.
INDICATION FOR OPERATION: Burn as above.
DESCRIPTION OF PROCEDURE: The patient was taken to the operating room where
general anesthesia was induced. Her right foot and thigh were sterilely prepped
and draped.
A Goulian knife with an 8 guard was readied and the burn was excised with the
knife after the tourniquet was inflated to 275. Once I was satisfied that I got
fresh wound bed for grafting, I covered it with epinephrine and saline soaked
sponges and turned to the right thigh. An appropriate sized piece of skin was
taken with the dermatome set at 12 thousandths. The skin was then returned to
the foot, and after hemostasis was obtained with local anesthetic injection
containing epinephrine in both the donor site and the foot, the skin graft was
lain down over the defect and sutured in place with running 5-0 Monocryl suture
around the edge and some interrupted in the middle. It was pie crusted in
scattered areas for drainage. Hemostasis was good at the end. It was covered
with Xeroform and wound VAC. The donor site was dressed with an OpSite. The
patient was then awakened, extubated, and taken to the recovery room in stable
condition. The entire procedure was well tolerated.
What I was thinking:
15120
15121
15004
15005