Wiki need debridement help TIA

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202
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Greer, SC
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pt in global by bypass

note 1 10180 ?

Procedure(s):
RIGHT GROIN/ ABDOMINAL INCISION & DRAINAGE, washout
Sharp, excisional debridement of subcutaneous tissue measuring 8 x 4 x 4 cm
Wound vac placement

Procedure Details:
The patient was taken to the operating room. Anesthesia was induced. The patient was placed in the supine position. A time out was performed. Antibiotics were addressed. The right groin and abdomen was prepped and draped in sterile fashion.

The previous incision was opened sharply with a scalpel. Purulent, thin, foul-smelling fluid was expressed from the superior incision. Two swab cultures were obtained. The remainder of the incision was opened sharply and wound explored. The previous graft was not exposed and the tissue overlying appeared healthy without signs of necrosis. The proximal portion of the wound contained the abscess cavity and this was drained. The abscess cavity was superficial and superior to the femoral vessels and no graft was exposed. There was no violation of external fascia and it appeared healthy. The wound was irrigated thoroughly with iricept. Sharp, excisional debridement of the subcutaneous tissue which contained necrotic, nonviable tissue was sharply excised with mayo scissors. Healthy punctate bleeding was noted. The excision extended to but not through the abdominal wall fascia. Total defect measured 8 x 4 x 4 cm. Hemostasis was achieved using electrocautery. The wound was irrigate a second time. A single piece of mepitel silver, non-adherent layer was placed within the wound bed and a wound vac was placed over this. Leak test was negative for leak and the vac was placed to continuous suction at 125 mmHg.

DIFFERENT DAYS

note 2 11042 11045 ?

Procedure(s):
Washout and wound vac change, R groin - all indicated procedure

Procedure Details:
After consent was obtained the patient was taken to the operative suite and laid in supine position. He was placed under general anesthesia and endotracheally intubated. The right groin and lower abdominal wound VAC was removed and area prepped and draped in usual sterile fashion. Proper timeout was performed and agreed upon by all parties present. Antibiotics were addressed. A sharp excisional debridement was performed using the scalpel and Metzenbaum scissors of the wound measuring 8 x 4 x 4 cm to include skin and subcutaneous tissue. The external oblique fascia is viable and intact. There is excellent punctate bleeding tissue. The graft is well covered and is not exposed within the wound. Aricept was used to irrigate the wound. Mepitel and black sponge placed in the incision and covered appropriately and connected to wound VAC device. Patient tolerated the procedure well was awakened from anesthesia and returned to recovery area in stable condition.
 
pt in global by bypass

note 1 10180 ?

Procedure(s):
RIGHT GROIN/ ABDOMINAL INCISION & DRAINAGE, washout
Sharp, excisional debridement of subcutaneous tissue measuring 8 x 4 x 4 cm
Wound vac placement

Procedure Details:
The patient was taken to the operating room. Anesthesia was induced. The patient was placed in the supine position. A time out was performed. Antibiotics were addressed. The right groin and abdomen was prepped and draped in sterile fashion.

The previous incision was opened sharply with a scalpel. Purulent, thin, foul-smelling fluid was expressed from the superior incision. Two swab cultures were obtained. The remainder of the incision was opened sharply and wound explored. The previous graft was not exposed and the tissue overlying appeared healthy without signs of necrosis. The proximal portion of the wound contained the abscess cavity and this was drained. The abscess cavity was superficial and superior to the femoral vessels and no graft was exposed. There was no violation of external fascia and it appeared healthy. The wound was irrigated thoroughly with iricept. Sharp, excisional debridement of the subcutaneous tissue which contained necrotic, nonviable tissue was sharply excised with mayo scissors. Healthy punctate bleeding was noted. The excision extended to but not through the abdominal wall fascia. Total defect measured 8 x 4 x 4 cm. Hemostasis was achieved using electrocautery. The wound was irrigate a second time. A single piece of mepitel silver, non-adherent layer was placed within the wound bed and a wound vac was placed over this. Leak test was negative for leak and the vac was placed to continuous suction at 125 mmHg.

DIFFERENT DAYS

note 2 11042 11045 ?

Procedure(s):
Washout and wound vac change, R groin - all indicated procedure

Procedure Details:
After consent was obtained the patient was taken to the operative suite and laid in supine position. He was placed under general anesthesia and endotracheally intubated. The right groin and lower abdominal wound VAC was removed and area prepped and draped in usual sterile fashion. Proper timeout was performed and agreed upon by all parties present. Antibiotics were addressed. A sharp excisional debridement was performed using the scalpel and Metzenbaum scissors of the wound measuring 8 x 4 x 4 cm to include skin and subcutaneous tissue. The external oblique fascia is viable and intact. There is excellent punctate bleeding tissue. The graft is well covered and is not exposed within the wound. Aricept was used to irrigate the wound. Mepitel and black sponge placed in the incision and covered appropriately and connected to wound VAC device. Patient tolerated the procedure well was awakened from anesthesia and returned to recovery area in stable condition.
That's what we would use with a 78 mod plus 97605 for the wound VAC.
 
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