Hi list and TGIF! 20525 only??
thanks!
M,CCS,CPC
DIAGNOSIS:
1. Right index finger flexor tenosynovitis and retained foreign body
POSTOP DIAGNOSIS:
1. Right index finger complex laceration with retained foreign body
2. Right index finger septic flexor tenosynovitis
3. Right index finger flexor tendon laceration
PROCEDURE:
1. Wound exploration Right index finger complex laceration
2. I&D Right index finger septic flexor tenosynovitis
3. Right index finger removal of foreign body, deep
ASSISTANT:
ANESTHESIA:
LMA.
TOURNIQUET TIME:
30 minutes.
BLOOD LOSS:
Minimal.
FLUIDS:
Per anesthesia record
OPERATIVE FINDINGS:
Rt index frank FT synovitis with retained 1x30mm wooden FBs x 2 , one within the FTS and one impaling the FDS tendon.
OPERATIVE SUMMARY IN DETAIL:
Following appropriate informed consent, patient identification, and operative limb, the patient was brought to the operating suite where smooth induction of LMA anesthesia was accomplished by Anesthesiology Service and the patient received broad-spectrum IV antibiotic prophylaxis. The Right upper extremity was prepped and draped in the usual sterile fashion. Time-out procedure performed. The limb was exsanguinated with an Esmarch bandage prior to tourniquet inflation to 275 mmHg. An ellipsing incision over the Right index finger puncture wound at the DPFC was carried out incorporating/excising the traumatic laceration. Blunt dissection was carried down through the subcutaneous tissues. The digital nerves were identified and retracted. The flexor tendon sheath was identified and distended with thin brown seropurulent fluid. A distal-oblique oriented 3 cm foreign body was impaling the FDS just distal to the A1 pulley and removed. A small FT laceration/punctiure tract was debrided. A Second loose 3 cm x 1mm wooden LB was removed from within the FTS as well. The A1 pulley was incised and the FT sheath decompressed, cultured and irrigated. A second FT aperture was made in the DIP flexion crease and further seropurulent fluid washed out as free flow was established. A plastic cannula was used to lavage the FT sheath. NO further purulence was noted and the procedure was terminated. Tourniquet was let down and the digits were viable and warm x 5. There was no undue bleeding. Hemostasis performed using electrocautery. The wounds were loosely reapproximated with nonabsorbable sutures and a 1/4 inch Penrose drain was placed in each wound. Sterile nonadherent dressing was applied. The patient was extubated and transported to the recovery area in stable condition. There were no intraoperative complications.
thanks!
M,CCS,CPC
DIAGNOSIS:
1. Right index finger flexor tenosynovitis and retained foreign body
POSTOP DIAGNOSIS:
1. Right index finger complex laceration with retained foreign body
2. Right index finger septic flexor tenosynovitis
3. Right index finger flexor tendon laceration
PROCEDURE:
1. Wound exploration Right index finger complex laceration
2. I&D Right index finger septic flexor tenosynovitis
3. Right index finger removal of foreign body, deep
ASSISTANT:
ANESTHESIA:
LMA.
TOURNIQUET TIME:
30 minutes.
BLOOD LOSS:
Minimal.
FLUIDS:
Per anesthesia record
OPERATIVE FINDINGS:
Rt index frank FT synovitis with retained 1x30mm wooden FBs x 2 , one within the FTS and one impaling the FDS tendon.
OPERATIVE SUMMARY IN DETAIL:
Following appropriate informed consent, patient identification, and operative limb, the patient was brought to the operating suite where smooth induction of LMA anesthesia was accomplished by Anesthesiology Service and the patient received broad-spectrum IV antibiotic prophylaxis. The Right upper extremity was prepped and draped in the usual sterile fashion. Time-out procedure performed. The limb was exsanguinated with an Esmarch bandage prior to tourniquet inflation to 275 mmHg. An ellipsing incision over the Right index finger puncture wound at the DPFC was carried out incorporating/excising the traumatic laceration. Blunt dissection was carried down through the subcutaneous tissues. The digital nerves were identified and retracted. The flexor tendon sheath was identified and distended with thin brown seropurulent fluid. A distal-oblique oriented 3 cm foreign body was impaling the FDS just distal to the A1 pulley and removed. A small FT laceration/punctiure tract was debrided. A Second loose 3 cm x 1mm wooden LB was removed from within the FTS as well. The A1 pulley was incised and the FT sheath decompressed, cultured and irrigated. A second FT aperture was made in the DIP flexion crease and further seropurulent fluid washed out as free flow was established. A plastic cannula was used to lavage the FT sheath. NO further purulence was noted and the procedure was terminated. Tourniquet was let down and the digits were viable and warm x 5. There was no undue bleeding. Hemostasis performed using electrocautery. The wounds were loosely reapproximated with nonabsorbable sutures and a 1/4 inch Penrose drain was placed in each wound. Sterile nonadherent dressing was applied. The patient was extubated and transported to the recovery area in stable condition. There were no intraoperative complications.