Help on this one....

Pre/Post DX:
Lt long finger infection, including distal phalanx tuft, with history revision Atasoy local advancement flap revision amputation 8/8/11

Procedure: I&D, left finger digit tip, with partial atasoy revision amputation

A hyponychial wedge excision performed, full-thickness, with Beaver blade, under loupe magnification, after removal of nail plate left long finger, including hyponychium several millimeter and residual tuft fragment present preop and distal nail bed, to the 50% nail bed level. This included granulation tissue and apparent presumed purulence and residual infection status post prior revision amputation digit tip trauma. Specimen sent for cultures.
Atosoy partial revision performed for flap coverage, including proximal radial, Proximal ulnar oblique incision. This allowed advancement over palmar flap for coverage dorsally with central 4-0 nylon stitch. Radial and ulnar sides were left open to allow drainage.

Cultures came back MRSA

10180 and 14040 998.59 041.12 V49.62.....YUCK!!!

Thanks all!!!