35901 Excision of infected graft; neck

Name of the Procedure:

Excision of Infected Graft; Neck (Graft Removal Surgery)

Summary

Excision of an infected graft in the neck involves surgically removing a previously implanted graft that has become infected. This is essential to control infection and prevent further complications.

Purpose

This procedure addresses infections that develop in grafts placed in the neck, often used in reconstructive surgeries or vascular grafting. The primary goal is to eliminate the infection, prevent its spread, and allow proper healing and potential subsequent placement of a new graft if needed.

Indications

• Persistent pain or swelling around the graft site.
• Redness and warmth indicating infection.
• Drainage of pus or other fluids from the graft site.
• Fever or other signs of systemic infection.
• Failure of antibiotics to control the infection.

Patients experiencing the above symptoms or those whose imaging or laboratory results show infection at the graft site are candidates for this procedure.

Preparation

• Patients are usually advised to fast for at least 8 hours before the procedure.
• Blood tests and imaging studies may be required to assess the extent of infection.
• Medications, especially blood thinners, may need to be adjusted or stopped.
• The surgical area will be cleaned and prepped to minimize infection risks.

Procedure Description

1. Anesthesia: General anesthesia is typically administered.
2. Incision: A surgical incision is made near the existing graft site.
3. Removal of Graft: The infected graft is carefully excised and removed.
4. Debridement: Surrounding infected tissues are cleaned and debrided.
5. Cultures and Samples: Tissue samples may be sent for culture to identify the infection type.
6. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Special surgical tools like scalpels, forceps, and possibly suction devices are used during the procedure.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and severity of the infection.

Setting

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

Personnel

• The procedure is led by a surgeon specialized in vascular or general surgery.
• A surgical team including nurses and surgical technologists assists.
• An anesthesiologist administers anesthesia and monitors the patient.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Damage to adjacent nerves or structures.
• Need for further surgery.
• Anesthesia-related complications.

Complications are managed through close monitoring, antibiotics, and, if necessary, additional surgical interventions.

Benefits

• Resolution of existing infection.
• Prevention of infection spread.
• Alleviation of symptoms like pain and swelling.
• Improved overall health and potential for enhanced quality of life post-recovery.

Benefits are typically noticed within days to a few weeks after the procedure.

Recovery

• Patients may be advised to stay in the hospital for a short period post-surgery.
• Pain and antibiotics medications may be prescribed.
• Instructions on wound care, activity restrictions, and signs of infection to watch for will be provided.
• Follow-up appointments will be scheduled to monitor healing.

Most patients can return to normal activities within a few weeks, but full recovery may take longer depending on the individual's health status and the severity of the infection.

Alternatives

• Antibiotic therapy alone (less effective if infection has spread or not responding).
• Percutaneous drainage (less invasive but may not fully address the infection).
• Revisional surgery for graft replacement (can be considered after infection control).

Each alternative has its pros and cons, and the choice depends on the infection's severity and patient-specific factors.

Patient Experience

During the procedure, patients will be under general anesthesia and will not feel pain. Post-procedure, they may experience discomfort or pain at the incision site, managed with prescribed pain relief. Patients should expect to follow recovery protocols and attend all follow-up appointments to ensure proper healing and monitor for any potential complications.