dsibley67
Networker
Do you feel this better supports 10060, since it resembles I&D, or could 11043 be supported, given the removal of fatty/soft tissue?
POSTOPERATIVE DIAGNOSIS: Abscess left hallux
PROCEDURE PERFORMED: I&D left hallux
PROCEDURE IN DETAIL: The patient was identified and placed on the treatment table in the supine
position. Following sedation, local anesthesia was obtained about the patient's left hallux with 10 cc of 2%
plain Xylocaine. Left hallux was then approached from the left medial portion of the hallux with linear
incision after ankle tourniquet inflated. Blunt dissection carried through to the bottom. No active abscess
noted, however abnormal serous brownish discharge noted in the space beneath the distal phalanx, not in
the joint surfaces. The soft tissues to the plantar skin were notably brownish and discolored fat adjacent
to the small ulceration or orifice to the plantar aspect of the distal pulp. Scar tissue had formed in the
circular pattern that was thick and irregular, that was excised with the fatty tissue. We irrigated with 2
liters of chlorhexidine impregnated normal sterile saline. Soft tissues were inspected without any additional
grommet needed. The interphalangeus was looked forward just dorsal to the flexor hallucis longus which
was negative for any excessive or hypertrophic notability. At this point, we closed the subcu with 3-0
Vicryl and skin closed with 4-0 nylon. Tourniquet was deflated and prompt hyperemic response noted,
one from the incision was evident. Pressure dressing applied with Adaptic, 4x4s, Kling and Ace bandage.
The patient tolerated the procedure and was transferred out of the treatment room with vital signs stable
and vascular status intact.
POSTOPERATIVE DIAGNOSIS: Abscess left hallux
PROCEDURE PERFORMED: I&D left hallux
PROCEDURE IN DETAIL: The patient was identified and placed on the treatment table in the supine
position. Following sedation, local anesthesia was obtained about the patient's left hallux with 10 cc of 2%
plain Xylocaine. Left hallux was then approached from the left medial portion of the hallux with linear
incision after ankle tourniquet inflated. Blunt dissection carried through to the bottom. No active abscess
noted, however abnormal serous brownish discharge noted in the space beneath the distal phalanx, not in
the joint surfaces. The soft tissues to the plantar skin were notably brownish and discolored fat adjacent
to the small ulceration or orifice to the plantar aspect of the distal pulp. Scar tissue had formed in the
circular pattern that was thick and irregular, that was excised with the fatty tissue. We irrigated with 2
liters of chlorhexidine impregnated normal sterile saline. Soft tissues were inspected without any additional
grommet needed. The interphalangeus was looked forward just dorsal to the flexor hallucis longus which
was negative for any excessive or hypertrophic notability. At this point, we closed the subcu with 3-0
Vicryl and skin closed with 4-0 nylon. Tourniquet was deflated and prompt hyperemic response noted,
one from the incision was evident. Pressure dressing applied with Adaptic, 4x4s, Kling and Ace bandage.
The patient tolerated the procedure and was transferred out of the treatment room with vital signs stable
and vascular status intact.