emilyadams1993@yahoo.com
Guest
PROCEDURE PERFORMED: wound exploration right upper extremity with excision of granuloma and foreign body. Primary closure.
Jimmie is a 55-year-old male with a history of infected graft which
was removed February 6, 2015. He had an infected graft and the graft
was removed and the wound was healed very well, except the distal wound
was not healing good. It was draining every day serous fluid, so the
plan was to explore this area. Possible there is a retained foreign
body reaction or still infected remnant piece of graft, so patient was
informed about the procedure and the risks and benefits were discussed
with the patient. Patient was taken to the operating room, put in the
supine position with the prevention of pressure ulcers, and he got 2
sequential devices on his calf muscles to prevent him from DVT. He got
3 g of Ancef and IV antibiotic before the incision, anesthesia sign-in,
and he got a block for his left upper extremity. We started our
procedure by scrubbing and draping in usual manner under sterile
technique for the left upper extremity, then we did the formal time-out.
Then we started our procedure by making an elliptical incision above the
area of unhealed wound, and we took down the incision and we dissected
all of the area there, bearing in mind to be away from the vital
structures. We took the dissection deep in the hand, did reach a hard
mass which was about 2 x 5 mm. It was like a foreign body and there was
reaction around it, and we took also about 3 mm from the remnant graft.
Then we oversewed the graft using a 4-0 Prolene running suture, and then
we approximated the area above it to obliterate the place using a 4-0
Dexon, and after that, we closed the skin using a 4-0 nylon vertical
mattress, and we irrigated the wound before we closed it with Betadine.
Would i use 35860??
Jimmie is a 55-year-old male with a history of infected graft which
was removed February 6, 2015. He had an infected graft and the graft
was removed and the wound was healed very well, except the distal wound
was not healing good. It was draining every day serous fluid, so the
plan was to explore this area. Possible there is a retained foreign
body reaction or still infected remnant piece of graft, so patient was
informed about the procedure and the risks and benefits were discussed
with the patient. Patient was taken to the operating room, put in the
supine position with the prevention of pressure ulcers, and he got 2
sequential devices on his calf muscles to prevent him from DVT. He got
3 g of Ancef and IV antibiotic before the incision, anesthesia sign-in,
and he got a block for his left upper extremity. We started our
procedure by scrubbing and draping in usual manner under sterile
technique for the left upper extremity, then we did the formal time-out.
Then we started our procedure by making an elliptical incision above the
area of unhealed wound, and we took down the incision and we dissected
all of the area there, bearing in mind to be away from the vital
structures. We took the dissection deep in the hand, did reach a hard
mass which was about 2 x 5 mm. It was like a foreign body and there was
reaction around it, and we took also about 3 mm from the remnant graft.
Then we oversewed the graft using a 4-0 Prolene running suture, and then
we approximated the area above it to obliterate the place using a 4-0
Dexon, and after that, we closed the skin using a 4-0 nylon vertical
mattress, and we irrigated the wound before we closed it with Betadine.
Would i use 35860??