Infected mesh removal, I & D, & tissue repair - NO CLUE

nlbarnes

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Escondido, CA
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I have codes - 11005 & 11008.

PROCEDURE PERFORMED:
Right groin infected mesh removal, incision and drainage, tissue
repair of right groin hernia.

OPERATIVE FINDINGS:
Large amount of pus in the right groin, infected mesh, that was
removed and sent for culture.

INDICATIONS FOR OPERATION:
She was brought to the operating room for debridement and mesh
removal.

DESCRIPTION OF PROCEDURE:
The prior incision was
opened with Kelly clamps and immediately a large amount of pus was
extravasated from the wound. The pus was then sent for culture and
Gram stain. The pus cavity extended all the way down to the mesh and
the mesh was all infected, all of the pus was suctioned out, all of
the mesh was removed from the inguinal area. The mesh plug and patch
was completely removed. The infected cavity was then pulse lavaged
with 2 L of bacitracin infused saline. Hemostasis was then achieved.
The operative area was surveyed. The conjoint tendon appeared to be
healthy and a relaxing incision was made medially. Laterally, the
tissues were hard to define due to the infection as well as the scar
tissue surrounding this area. The conjoint tendon was then brought
reapproximated what appeared to be the external oblique laterally with
interrupted 2-0 Vicryl sutures. There was a cavity below this repair,
where the mesh plugs had been placed previously, and therefore, a 19-
French Blake drain was then placed into this cavity. The Scarpa's
fascia was then reapproximated with running 2-0 Vicryl suture and the
skin was reapproximated over a Penrose drain with staples. The
patient was then awoken from anesthesia and brought to the PACU in
good and stable condition.
 
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