49900 Suture, secondary, of abdominal wall for evisceration or dehiscence

Name of the Procedure:

Suture, Secondary, of Abdominal Wall for Evisceration or Dehiscence

Summary

This procedure involves stitching the abdominal wall to repair an opening or separation that occurs after initial surgery. This can be necessary if the surgical wound reopens or if internal organs protrude through the incision.

Purpose

The procedure addresses evisceration (protrusion of internal organs) or dehiscence (reopening of a surgical wound). The goal is to close the wound, prevent infection, and ensure proper healing of the abdominal wall.

Indications

• Visible reopening of a surgical incision on the abdomen.
• Protrusion of internal organs through the surgical site.
• Infection or delayed healing of an abdominal wound.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjustments or temporary discontinuation of certain medications (e.g., blood thinners).
• Preoperative physical examination and imaging tests like ultrasound or CT scan.

Procedure Description

1. The patient is administered general anesthesia.
2. The surgical area is cleaned and sterilized.
3. An incision is made to expose the affected area of the abdominal wall.
4. The surgeon inspects and, if necessary, repositions the internal organs.
5. The abdominal muscles and layers are carefully sutured to ensure a secure closure.
6. The skin is stitched or stapled.
7. A sterile dressing is applied to the incision site.

Duration

The procedure typically takes 1 to 2 hours, depending on the extent of the repair needed.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Primary Surgeon
• Surgical Assistants
• Anesthesiologist
• Operating Room Nurses

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Risk of anesthetic complications.
• Scar formation or poor wound healing.
• Recurrent dehiscence or hernia.

Benefits

• Successful closure of the abdominal wound.
• Prevention of further complications such as infection or organ damage.
• Improved wound healing and recovery.

Recovery

• Hospital stay for a few days post-procedure for monitoring.
• Follow-up appointments to check on wound healing.
• Instructions for wound care, including keeping the area clean and dry.
• Restrictions on heavy lifting or strenuous activities for several weeks.
• Pain management with prescribed medications.

Alternatives

• Non-surgical wound care, although this may be less effective in severe cases.
• Negative pressure wound therapy (NPWT) for specific types of wound healing.
• Each alternative comes with its own risks and benefits, which should be discussed with a healthcare provider.

Patient Experience

• Under anesthesia, the patient will be unconscious and pain-free during the procedure.
• Postoperatively, there may be discomfort at the incision site, managed with pain medications.
• Patients should expect to feel some soreness and will receive instructions on how to move and care for their wound to promote healing.