rrizzo5607
New
I need some help with the removal of acellular dermal matrix. Tissue expander was removed as well as the alloderm. Neither had been replaced. Any help with the alloderm removal is much appreciated.
The necrotic skin at the mastectomy incision was first sharply debrided with a #15 blade scalpel. This ultimately measured 10x1cm of debridement. On finishing the debridement, serous drainage was noted. The mastectomy pocket was then entered bluntly with some cloudy serous drainage noted. The alloderm had not yet incorporated. Decision was made to remove the tissue expander and alloderm out of concern for possible infection. The sutures anchoring both the expander and alloderm were cut and both the expander and alloderm were removed. The pocket was first mechanically debrided and then copiously irrigated with normal saline. A 19Fr Blake drain was placed into the pocket and brought out laterally through the skin. This was sutured in placed with a 3-0 nylon stitch. The pocket was then closed with interrupted 3-0 monocryl in the deep dermis and a running 4-0 monocryl subcuticular. Steri-strips and ABD pads were then applied.
The necrotic skin at the mastectomy incision was first sharply debrided with a #15 blade scalpel. This ultimately measured 10x1cm of debridement. On finishing the debridement, serous drainage was noted. The mastectomy pocket was then entered bluntly with some cloudy serous drainage noted. The alloderm had not yet incorporated. Decision was made to remove the tissue expander and alloderm out of concern for possible infection. The sutures anchoring both the expander and alloderm were cut and both the expander and alloderm were removed. The pocket was first mechanically debrided and then copiously irrigated with normal saline. A 19Fr Blake drain was placed into the pocket and brought out laterally through the skin. This was sutured in placed with a 3-0 nylon stitch. The pocket was then closed with interrupted 3-0 monocryl in the deep dermis and a running 4-0 monocryl subcuticular. Steri-strips and ABD pads were then applied.