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Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness

CPT4 code

Name of the Procedure:

  • Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness
  • Common names: Eyelid wound repair, Eyelid suture, Eyelid laceration repair

Summary

This procedure involves closing a recent eyelid wound that affects the lid margin, tarsus (the dense connective tissue of the eyelid), and/or the palpebral conjunctiva (the inner lining of the eyelid) using sutures. This is done to restore the normal structure and function of the eyelid.

Purpose

The purpose of this procedure is to treat eyelid injuries by:

  • Ensuring proper healing.
  • Preventing infection.
  • Maintaining the functionality and appearance of the eyelid.

Indications

  • Recent trauma or laceration to the eyelid.
  • Wounds that involve the lid margin, tarsus, and/or palpebral conjunctiva.
  • Patients requiring restoration of eyelid function and aesthetics.

Preparation

  • Follow instructions for fasting if necessary (usually more relevant if general anesthesia is used).
  • Adjust any medications as advised by the healthcare provider.
  • Complete any required diagnostic tests, such as eye examinations or imaging studies.

Procedure Description

  1. Anesthesia: Local anesthesia is commonly used; sedation or general anesthesia may be used for more extensive injuries or in certain patient populations.
  2. Cleaning: The wound area is cleaned and disinfected.
  3. Assessment: An assessment of the wound is performed to plan the suturing technique.
  4. Suturing: The wound is closed in layers. The conjunctiva is typically sutured first, followed by deeper layers, and finally the skin.
  5. Tools/Equipment: Fine sutures, needle holder, forceps, and possibly magnifying loupes for precise work.

Duration

The procedure typically takes between 30 minutes to 1 hour, depending on the complexity of the wound.

Setting

  • This procedure can be performed in a hospital, outpatient clinic, or surgical center.

Personnel

  • Ophthalmic or plastic surgeon.
  • Anesthesiologist or nurse anesthetist (if sedation or general anesthesia is used).
  • Surgical nurses or assistants.

Risks and Complications

  • Common risks: Infection, bleeding, pain at the site.
  • Rare risks: Poor wound healing, scarring, eyelid deformity, vision impairment, or need for additional surgeries.

Benefits

  • Successful healing of the eyelid wound.
  • Restoration of normal eyelid function and appearance.
  • Pain and discomfort relief.
  • Prevention of complications such as infection.

Recovery

  • Follow wound care instructions, including cleaning and protecting the area.
  • Use prescribed medications (e.g., antibiotics, pain relievers, and anti-inflammatory drugs).
  • Avoid strenuous activities and follow any additional restrictions.
  • Attend follow-up appointments to monitor healing.

Alternatives

  • Non-surgical management for very minor wounds.
  • Other surgical techniques depending on the extent of the injury.
  • Each alternative has its pros and cons which should be discussed with a healthcare provider.

Patient Experience

  • The patient might feel pressure or minor discomfort during the procedure if local anesthesia is used.
  • Post-procedure, there might be moderate pain, swelling, or bruising which can be managed with medication.
  • Healing typically occurs over a few weeks, during which the patient should follow care instructions for optimal recovery.

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