rkindlund
Networker
I am stumped on this one, people. Any help would be appreciated.
POSTOPERATIVE DIAGNOSES: Status post re-excision of pilonidal cyst with
bleeding from wound VAC plus bleeding from gluteal muscle vessels. .
ANESTHESIA: General endotracheal anesthesia.
INTRAVENOUS FLUIDS: One liter of crystalloid.
ESTIMATED BLOOD LOSS: 500 mL.
PROCEDURE: Gluteal exploration, removal of wound VAC and ligation and control
of bleeding vessels.
INDICATION FOR PROCEDURE: This is a 22-year-old male who had undergone a
re-excision of pilonidal cyst … who had been recently discharged with negative
pressure wound therapy for wound management. The patient had been doing fine
until the day of surgery when he began to pour out copious amounts of bloody
fluid and removed his negative pressure wound therapy and had filled 2 canisters
in a matter of 2 hours. The patient was brought to the emergency room by EMTs
and was urgently taken to the operating room.
The patient was brought to the operating room and placed on the operating room
table in jackknife prone position. After successful general anesthesia had been
induced, the wound VAC was removed and the gluteal area was prepped and draped
in the usual sterile fashion. There was a copious amount of bloody clot in the
wound VAC canister and in the gluteal cleft large clot. The patient was found
to have bleeding from gluteal muscle vessels. These were small little vessels
that were bleeding in multiple places. Hemostasis was achieved with Bovie
cautery, as well as ligation of gluteal vessels with figure-of-8 Vicryl
stitches. The gluteal cleft region was irrigated with copious amounts of saline
until the effluent was clear and hemostasis was achieved with Bovie cautery, as
well as Vicryl stitches. I then proceeded to place saline-soaked Kling into the
gluteal cleft and topped with dry gauze. Hemostasis was achieved. The patient
was then awoken and taken to recovery room in stable condition.
POSTOPERATIVE DIAGNOSES: Status post re-excision of pilonidal cyst with
bleeding from wound VAC plus bleeding from gluteal muscle vessels. .
ANESTHESIA: General endotracheal anesthesia.
INTRAVENOUS FLUIDS: One liter of crystalloid.
ESTIMATED BLOOD LOSS: 500 mL.
PROCEDURE: Gluteal exploration, removal of wound VAC and ligation and control
of bleeding vessels.
INDICATION FOR PROCEDURE: This is a 22-year-old male who had undergone a
re-excision of pilonidal cyst … who had been recently discharged with negative
pressure wound therapy for wound management. The patient had been doing fine
until the day of surgery when he began to pour out copious amounts of bloody
fluid and removed his negative pressure wound therapy and had filled 2 canisters
in a matter of 2 hours. The patient was brought to the emergency room by EMTs
and was urgently taken to the operating room.
The patient was brought to the operating room and placed on the operating room
table in jackknife prone position. After successful general anesthesia had been
induced, the wound VAC was removed and the gluteal area was prepped and draped
in the usual sterile fashion. There was a copious amount of bloody clot in the
wound VAC canister and in the gluteal cleft large clot. The patient was found
to have bleeding from gluteal muscle vessels. These were small little vessels
that were bleeding in multiple places. Hemostasis was achieved with Bovie
cautery, as well as ligation of gluteal vessels with figure-of-8 Vicryl
stitches. The gluteal cleft region was irrigated with copious amounts of saline
until the effluent was clear and hemostasis was achieved with Bovie cautery, as
well as Vicryl stitches. I then proceeded to place saline-soaked Kling into the
gluteal cleft and topped with dry gauze. Hemostasis was achieved. The patient
was then awoken and taken to recovery room in stable condition.