21510 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), thorax

Name of the Procedure:

Incision, deep, with opening of bone cortex (e.g., for osteomyelitis or bone abscess), thorax

Summary

This surgical procedure involves making a deep incision in the chest area to access and open the bone cortex. It is typically performed to treat infections within the bone, such as osteomyelitis or bone abscesses.

Purpose

The procedure is designed to address serious infections within the bone of the thorax, such as osteomyelitis or bone abscesses. The goal is to remove infected tissue, drain abscesses, and allow for effective treatment to prevent the spread of infection and promote healing.

Indications

The procedure is indicated for patients who exhibit:

• Persistent, severe pain in the chest associated with bone infection.
• Swelling and redness over the affected area.
• Fever and other signs of infection resistant to medication.
• Diagnosed osteomyelitis or bone abscess not responsive to conservative treatment.

Preparation

Patients may need to:

• Fast for several hours prior to surgery.
• Refrain from taking certain medications that could affect blood clotting.
• Undergo imaging tests like X-rays or MRIs to precisely locate the infection.
• Undergo blood tests to assess overall health and infection status.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient remains unconscious and pain-free.
2. Incision: A deep incision is made over the thoracic area where the infection is located.
3. Opening Cortex: The surgeon carefully opens the bone cortex to access the infected area within the bone.
4. Drainage and Debridement: Any abscesses are drained, and infected bone tissue is removed.
5. Closure: The incision is cleaned and closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 1-3 hours, depending on the complexity and extent of the infection.

Setting

This surgery is performed in a hospital operating room or a specialized surgical center.

Personnel

The procedure involves:

• A thoracic surgeon.
• An anesthesiologist.
• Surgical nurses.
• Operating room technicians.

Risks and Complications

Common risks include:

• Infection at the incision site.
• Bleeding.
• Pain and swelling.
• Anesthesia-related complications. Rare risks include:
• Damage to surrounding tissues or structures.
• Chronic pain.
• Failure to completely eliminate the infection, necessitating further treatment.

Benefits

The expected benefits include:

• Relief of pain and other infection-related symptoms.
• The prevention of spread or worsening of the infection.
• Increased likelihood of complete healing of the affected bone.

Recovery

Post-procedure care includes:

• Pain management with medications.
• Antibiotic therapy to treat residual infection.
• Instructions to keep the incision site clean and dry.
• Limited physical activity for a specified period.
• Follow-up appointments to monitor healing.

Alternatives

Alternative treatments may include:

• Prolonged antibiotic therapy.
• Minimally invasive drainage procedures.
• Hyperbaric oxygen therapy. While these may be less invasive, they may not be as effective for severe infections requiring surgical intervention.

Patient Experience

During the procedure, the patient will be under general anesthesia and feel no pain. Recovery may involve moderate discomfort, which is manageable with prescribed pain medications. Patients can expect swelling and soreness in the surgical area, gradually improving over several weeks. Pain and activity restrictions will be discussed to ensure optimal recovery.