Any help would be appreciated for the following surgical report.
Procedure(s)
Debridement of exposed necrotic pulsating cortical surface
Morselization of surrounding parietal bone for culture
Onlay dura repair over exposed cortical Pial surface
Operative Note:
Call to the OR by Dr. XX regarding resection of evident cranial defect with pulsatile brain above level of dura. No evidence of purulence, no discharge. Necrotic bone under various stages resorption
pial surface was cauterized. No evident purulent cortical brain matter seen, dural defect allowing for externalized brain notable bony defect as well as various areas of resorptive cranial defects including non contiguous site to defect area. Lempert rongeur was utilized to morselized bone for culture, no possibility of dura repair. Onlay dura repair was then utilized to cover the cortical surface area bone under various stages, resorption with infection as well as post radiation area of bone and scalp would not be amenable to cranial mesh. Given exposed and herniated cortical contents, defect left open with onlay dura repair covering cortical surface. See plastic surgery discussion regarding viability of flap reconstruction.
Thank You for any assistance.
Procedure(s)
Debridement of exposed necrotic pulsating cortical surface
Morselization of surrounding parietal bone for culture
Onlay dura repair over exposed cortical Pial surface
Operative Note:
Call to the OR by Dr. XX regarding resection of evident cranial defect with pulsatile brain above level of dura. No evidence of purulence, no discharge. Necrotic bone under various stages resorption
pial surface was cauterized. No evident purulent cortical brain matter seen, dural defect allowing for externalized brain notable bony defect as well as various areas of resorptive cranial defects including non contiguous site to defect area. Lempert rongeur was utilized to morselized bone for culture, no possibility of dura repair. Onlay dura repair was then utilized to cover the cortical surface area bone under various stages, resorption with infection as well as post radiation area of bone and scalp would not be amenable to cranial mesh. Given exposed and herniated cortical contents, defect left open with onlay dura repair covering cortical surface. See plastic surgery discussion regarding viability of flap reconstruction.
Thank You for any assistance.