heatherposchman1
Networker
Procedure: Partial amputation of 4th toe, left foot
OP note excerpt:
"It was determined that additional bone resection was necessary for closure of the tissue flap. Medial and lateral adhesions were excised to allow for adequate exposure of the head of the middle phalanx. The head of the middle phalanx was resected with a bone cutter and sent as a clearance piece to pathology. The bone was rasp until a smooth contour was achieved. The extensor and flexor tendons were pulled out to length and resected proximally. Site was thoroughly irrigated. Using the Misonix neXus ultrasonic debrider the surrounding wound base was debrided to optimize tissue for allograft application. The remaining wound base was noted with a granular tissue base. Applied a 24 mm Therion allograft to the wound base to optimize tissue healing of wound. The plantar tissue was flapped dorsally and attached with 4-0 nylon to the dorsal tissue with simple suture technique. Good capillary refilled time was noted to the distal flap site"
OP note excerpt:
"It was determined that additional bone resection was necessary for closure of the tissue flap. Medial and lateral adhesions were excised to allow for adequate exposure of the head of the middle phalanx. The head of the middle phalanx was resected with a bone cutter and sent as a clearance piece to pathology. The bone was rasp until a smooth contour was achieved. The extensor and flexor tendons were pulled out to length and resected proximally. Site was thoroughly irrigated. Using the Misonix neXus ultrasonic debrider the surrounding wound base was debrided to optimize tissue for allograft application. The remaining wound base was noted with a granular tissue base. Applied a 24 mm Therion allograft to the wound base to optimize tissue healing of wound. The plantar tissue was flapped dorsally and attached with 4-0 nylon to the dorsal tissue with simple suture technique. Good capillary refilled time was noted to the distal flap site"