lisacda68
Contributor
Here's the OP Report...hheeellllppppp
PREOPERATIVE DIAGNOSIS: Multiple verrucae, left foot, as well as a single verruca on the right.
POSTOPERATIVE DIAGNOSIS: Multiple verrucae, left foot, as well as a single verruca on the right.
PROCEDURE PERFORMED: Left foot Panacos procedure.
ANESTHESIA: IV sedation with a local block to field block abductor muscle, left foot, as well as field block to wart excision location, left foot.
HEMOSTASIS: Ankle tourniquet at 250 mmHg. Please seen anesthesia notes for details on duration.
ESTIMATED BLOOD LOSS: Less than 2 mL.
MATERIALS LEFT IN THE BODY: The prepared wart, which was implanted into the abductor muscle, as well as 3-0 Vicryl and a 4-0 Prolene.
INJECTABLES: 2 mL of a 0.5% Marcaine plain.
PATHOLOGY: None sent.
COMPLICATIONS: None.
PROCEDURE IN DETAIL: The patient was identified. The limb and the appropriate surgery were reviewed one final time before any sedation was started, and the foot was marked by myself. Once confirmation of appropriate surgery and appropriate location, the patient was placed on the OR bed in a supine position, and IV sedation was started. The tourniquet was placed around the left ankle, and after a local infiltration of anesthesia as described, the foot was scrubbed and prepped in a sterile manner. After Esmarch, the tourniquet was inflated to 250 mmHg.
A linear incision in preparation for the implantation of the muscle was made. This linear incision was deepened to the abductor muscle, and a small fascial incision was made with the tenotomy scissors. The wart was then
excised from the nonweightbearing surface and prepared, removing any hyperkeratosis and only using the underlying warty tissue, which allowed us to implant the verruca into the abductor muscle.
Once the wart was implanted, 3-0 Vicryl was utilized to close the deep layer overlying this implantation followed by 4-0 Prolene in a horizontal mattress fashion to the skin layer. The implantation and handling of each of the locations was done by separate instrumentation to reduce the chance of spread to the verruca to the skin layer on the abductor muscle incision. Cautery was used to the wart location followed by a copious amount of antibiotic ointment. Please note, prior to any closure and prior to coverage with antibiotic ointment, the areas underwent a copious lavage with saline. Once ointment was in place, Adaptic was placed over both locations followed by 4 x 4's, fluffs, Kerlix, and an Ace bandage. The patient has instructions to rest, ice, elevate, use pain medication as needed, use postoperative shoe as described, and the patient is to follow up in 3-5 days' time as arranged preoperatively.
Can someone point me in the direction I need to look for codes????? Helllpppppp
Thank you
Lisa
PREOPERATIVE DIAGNOSIS: Multiple verrucae, left foot, as well as a single verruca on the right.
POSTOPERATIVE DIAGNOSIS: Multiple verrucae, left foot, as well as a single verruca on the right.
PROCEDURE PERFORMED: Left foot Panacos procedure.
ANESTHESIA: IV sedation with a local block to field block abductor muscle, left foot, as well as field block to wart excision location, left foot.
HEMOSTASIS: Ankle tourniquet at 250 mmHg. Please seen anesthesia notes for details on duration.
ESTIMATED BLOOD LOSS: Less than 2 mL.
MATERIALS LEFT IN THE BODY: The prepared wart, which was implanted into the abductor muscle, as well as 3-0 Vicryl and a 4-0 Prolene.
INJECTABLES: 2 mL of a 0.5% Marcaine plain.
PATHOLOGY: None sent.
COMPLICATIONS: None.
PROCEDURE IN DETAIL: The patient was identified. The limb and the appropriate surgery were reviewed one final time before any sedation was started, and the foot was marked by myself. Once confirmation of appropriate surgery and appropriate location, the patient was placed on the OR bed in a supine position, and IV sedation was started. The tourniquet was placed around the left ankle, and after a local infiltration of anesthesia as described, the foot was scrubbed and prepped in a sterile manner. After Esmarch, the tourniquet was inflated to 250 mmHg.
A linear incision in preparation for the implantation of the muscle was made. This linear incision was deepened to the abductor muscle, and a small fascial incision was made with the tenotomy scissors. The wart was then
excised from the nonweightbearing surface and prepared, removing any hyperkeratosis and only using the underlying warty tissue, which allowed us to implant the verruca into the abductor muscle.
Once the wart was implanted, 3-0 Vicryl was utilized to close the deep layer overlying this implantation followed by 4-0 Prolene in a horizontal mattress fashion to the skin layer. The implantation and handling of each of the locations was done by separate instrumentation to reduce the chance of spread to the verruca to the skin layer on the abductor muscle incision. Cautery was used to the wart location followed by a copious amount of antibiotic ointment. Please note, prior to any closure and prior to coverage with antibiotic ointment, the areas underwent a copious lavage with saline. Once ointment was in place, Adaptic was placed over both locations followed by 4 x 4's, fluffs, Kerlix, and an Ace bandage. The patient has instructions to rest, ice, elevate, use pain medication as needed, use postoperative shoe as described, and the patient is to follow up in 3-5 days' time as arranged preoperatively.
Can someone point me in the direction I need to look for codes????? Helllpppppp
Thank you
Lisa