Anesthesia for sternal debridement
CPT4 code
Name of the Procedure:
Anesthesia for Sternal Debridement (Commonly referred to as Sternal Debridement Anesthesia)
Summary
Sternal debridement is a surgical procedure to remove infected, dead, or damaged tissue from the sternum (breastbone) to help promote healing. The anesthesia used during this procedure ensures that the patient remains pain-free and unaware during surgery.
Purpose
This procedure addresses infections, non-healing wounds, or other complications associated with the sternum often following cardiac surgery. The primary goal is to eliminate the diseased tissue, prevent the spread of infection, and promote a favorable environment for healing.
Indications
- Deep sternal wound infections.
- Chronic osteomyelitis of the sternum.
- Non-healing sternal wounds post-cardiac surgery.
- Severe chest pain or discomfort attributable to sternal infections.
Preparation
- Patients are often advised to fast (no food or drink) for at least 8 hours before the procedure.
- Adjustment or cessation of certain medications as directed by the healthcare provider.
- Pre-operative diagnostic tests, including blood work, ECG, and imaging studies to assess the sternum.
Procedure Description
- Anesthesia Administration: General anesthesia is administered through an IV line, inducing sleep and ensuring the patient remains unconscious and pain-free.
- Surgical Prep: The chest area is sterilized to reduce the risk of infection.
- Incision and Debridement: The surgeon makes an incision over the sternum to access the infected or damaged tissue, which is then carefully removed.
- Closure: Depending on the extent of the debridement, the incision is either closed with sutures or left open and packed for better drainage.
- Monitoring: Continuous monitoring of vital signs throughout the procedure.
Duration
The procedure typically takes 1 to 3 hours, depending on the extent of the infection and the amount of tissue that needs removal.
Setting
This procedure is usually performed in a hospital operating room.
Personnel
- Surgeons specialized in cardiac or thoracic surgery.
- Anesthesiologist to administer and monitor anesthesia.
- Surgical nurses and technicians.
- Post-operative care team.
Risks and Complications
- Infection.
- Bleeding.
- Adverse reactions to anesthesia.
- Respiratory complications.
- Potential for prolonged hospital stay due to wound healing requirements.
Benefits
- Removal of infected or necrotic tissue.
- Reduced risk of further infection.
- Alleviation of pain and other symptoms.
- Improved overall healing and recovery prospects.
Recovery
- Patients are typically monitored in a recovery room for several hours immediately post-surgery.
- Hospital stay could range from a few days to several weeks, depending on the extent of the procedure and patient recovery.
- Follow-up visits for wound care and monitoring healing.
- Restrictions on physical activity to allow proper healing.
Alternatives
- Antibiotic therapy: Less invasive but may not be sufficient for severe infections.
- Vacuum-assisted closure (VAC) therapy: Can be used for less severe sternal wounds.
- Hyperbaric oxygen therapy: Used to promote healing in certain cases.
- Each alternative has its own set of benefits and limitations, and suitability varies based on the patient’s condition.
Patient Experience
- Patients will be under general anesthesia and will not feel anything during the procedure.
- Post-operatively, patients might experience pain or discomfort managed with medications.
- Instructions on wound care, activity restrictions, and signs of complications to watch for will be provided.
- Recovery periods vary, and adherence to follow-up care is crucial for successful healing.