PREOPERATIVE DIAGNOSIS: Status post fasciotomy for trauma, right…

PREOPERATIVE DIAGNOSIS: Status post fasciotomy for trauma, right thigh, for compartment syndrome. PREOPERATIVE DIAGNOSIS: Status post fasciotomy for trauma, right thigh, for compartment syndrome. POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Secondary closure, right thigh wound. SURGEON: George Pathfinder, MD ANESTHESIA: General. FINDINGS: The wound vac seems to have reduced the volume of the thigh fairly nicely and we were able to close the skin without any undue tension. The wound itself looked clean and there was no evidence of any purulent material at all. PROCEDURE: While under a general anesthetic, the patient was placed in the supine position on the operating room table. The wound vac was removed from the patient’s thigh and the wound appeared to be very clean without any purulent material at all. We then prepped the patient’s right leg with Betadine and draped it in a sterile fashion. We then initially used a SurgiLav device with saline and a sponge to scrub the incision and irrigated very thoroughly. After this, we attempted to see if the quadriceps would contract by pinching it with a forceps. We were able to pinch the quadriceps in several areas and it seemed to respond quite nicely. We then began the extensive closure of the wound from each end using 2-0 Vicryl suture. We were actually able to pull the wound together quite nicely without any undue tension. We were then able to close the skin using skin staples. With the wound closed, we could flex the knee approximately 90 degrees. We then dressed the wound with Xeroform gauze dressings under 4 x 4s, ABD pads, and an ACE wrap. The dorsalis pedis pulse was strong at the end of the procedure. He was taken from the operating room in good condition and breathing spontaneously. He was given IV Kefzol preoperatively and will be continued on IV Kefzol postoperatively as well. He tolerated the procedure very well. We then initially used a SurgiLav device with saline and a sponge to scrub the incision and irrigated very thoroughly. After this, we attempted to see if the quadriceps would contract by pinching it with a forceps. We were able to pinch the quadriceps in several areas and it seemed to respond quite nicely. We then began the extensive closure of the wound from each end using 2-0 Vicryl suture. We were actually able to pull the wound together quite nicely without any undue tension. We were then able to close the skin using skin staples. With the wound closed, we could flex the knee approximately 90 degrees. We then dressed the wound with Xeroform gauze dressings under 4 x 4s, ABD pads, and an ACE wrap. The dorsalis pedis pulse was strong at the end of the procedure. He was taken from the operating room in good condition and breathing spontaneously. He was given IV Kefzol preoperatively and will be continued on IV Kefzol postoperatively as well. He tolerated the procedure very well. Procedure Key Terms: closure, secondary, extensive ICD-10-CM Key Terms: syndrome, compartment, traumatic, lower extremity