23174 Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck

Name of the Procedure:

Sequestrectomy (e.g., for osteomyelitis or bone abscess), humeral head to surgical neck

Summary

A sequestrectomy involves the surgical removal of a sequestrum, which is a piece of dead bone that has become separated from healthy bone tissue, often due to an infection such as osteomyelitis or an abscess.

Purpose

The procedure aims to treat infections within the bone, particularly in the humeral head to surgical neck region. By removing the dead bone, the procedure helps to eradicate the infection, prevent its spread, and promote healing.

Indications

• Persistent or recurrent bone infection (osteomyelitis).
• Presence of a bone abscess.
• Radiological evidence of dead bone tissue (sequestrum).
• Failure of non-surgical treatments to resolve infection.

Preparation

• Patients may be required to fast for several hours before the procedure.
• Blood tests, imaging studies (e.g., X-rays, MRI), and pre-operative assessments will be conducted.
• Adjustment of medications, especially blood thinners, may be necessary.

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made over the affected area of the humerus to expose the bone.
3. Careful dissection is performed to reach the sequestrum.
4. The dead bone (sequestrum) is removed using specialized surgical instruments.
5. The area is cleaned thoroughly to remove any remaining infection.
6. Sometimes, bone grafts or antibiotics-infused materials are placed in the defect to aid healing.
7. The incision is closed with sutures or staples and bandaged.

Duration

The procedure typically takes around 1 to 3 hours, depending on the severity and extent of the infection.

Setting

The sequestrectomy is performed in a hospital operating room or a surgical center.

Personnel

• Orthopedic surgeon.
• Anesthesiologist.
• Surgical nurses and assistants.

Risks and Complications

• Infection at the surgical site.
• Blood loss.
• Damage to surrounding nerves or blood vessels.
• Incomplete removal of infected tissue.
• Recurrence of infection.
• Delayed healing.

Benefits

• Elimination of infection.
• Relief from pain and discomfort caused by the bone infection.
• Improved function and mobility of the affected limb.
• Reduction of systemic infection risk.

Recovery

• Post-operative care involves pain management and antibiotics.
• The arm may be immobilized using a sling or brace.
• Follow-up appointments are crucial for monitoring healing.
• Physical therapy may be recommended to restore strength and mobility.
• Recovery time varies but generally ranges from a few weeks to several months.

Alternatives

• Long-term antibiotic therapy alone.
• Drainage of abscesses without bone removal.
• Hyperbaric oxygen therapy. Pros and cons of alternatives should be discussed with a healthcare provider to determine the most appropriate course of action.

Patient Experience

• Patients will be under general anesthesia and will not feel pain during the procedure.
• Post-surgical pain and swelling can be managed with medication.
• Mild to moderate discomfort may be experienced during the initial recovery phase.
• Physical therapy and follow-up care are important for a smooth recovery process.