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Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm

CPT4 code

Name of the Procedure:

Repair, intermediate, wounds of neck, hands, feet, and/or external genitalia; 12.6 cm to 20.0 cm. Commonly referred to as "intermediate wound repair" for specific body areas.

Summary

Intermediate wound repair is a medical procedure to close and heal wounds that are between 12.6 cm and 20.0 cm in length on the neck, hands, feet, or external genitalia. The procedure goes beyond simple closure, involving layered suturing for deeper repair.

Purpose

This procedure is performed to treat lacerations or incisions that are too deep or extensive for basic wound closure. The goal is to ensure proper healing, minimize scarring, and restore function to the affected area.

Indications

  • Deep cuts or lacerations on the neck, hands, feet, or external genitalia.
  • Wounds that extend through multiple layers of tissue.
  • Traumatic injuries or surgical incisions requiring layered closure.

Preparation

  • Patients may need to fast for several hours before the procedure if general anesthesia is used.
  • Medications such as blood thinners should be adjusted in consultation with a healthcare provider.
  • Diagnostic tests like blood work or imaging might be required to assess the extent of the injury.

Procedure Description

  1. Anesthesia: Local or general anesthesia is administered based on the wound's location and complexity.
  2. Wound Cleaning: The wound is thoroughly cleaned to reduce infection risk.
  3. Layered Suturing: Deeper layers of tissue are sutured first, followed by the outer layers to ensure a strong and secure closure.
  4. Dressing: The wound is dressed with sterile bandages, and sometimes a splint may be applied to immobilize the area.

Duration

The procedure typically takes 30 minutes to 1 hour, depending on the wound's size and complexity.

Setting

Usually performed in a hospital's emergency department, outpatient clinic, or surgical center.

Personnel

  • Surgeons or specialized wound care physicians
  • Nurses
  • Anesthesiologists (if general anesthesia is used)

Risks and Complications

  • Infection
  • Scarring
  • Wound dehiscence (reopening)
  • Nerve or tissue damage
  • Allergic reaction to anesthesia

Benefits

  • Effective wound closure
  • Reduced risk of infection
  • Better cosmetic and functional outcomes
  • Faster healing compared to untreated or improperly treated wounds

Recovery

  • Keep the wound clean and dry.
  • Follow specific instructions for wound care provided by the healthcare team.
  • Avoid strenuous activities that might stress the wound.
  • Follow-up appointments to monitor healing are typically scheduled within 7 to 14 days.
  • Full recovery can take several weeks, depending on the wound's severity and location.

Alternatives

  • Simple Repair: For less extensive wounds; may not provide as robust a closure.
  • Advanced Surgical Techniques: In cases of extremely extensive or complex wounds.
  • Non-surgical management: Includes wound care and monitoring, but may not be appropriate for deeper wounds.

Patient Experience

  • Mild to moderate discomfort during the procedure, especially when local anesthesia is used.
  • Post-procedure pain can be managed with prescribed pain relief medication.
  • Swelling, bruising, and tenderness around the wound site are common but typically subside within a few days.
  • Patients are advised to follow strict wound care instructions to ensure optimal healing and avoid complications.

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