Name of the Procedure:

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm
Common name(s): Intermediate wound repair

Summary

Intermediate wound repair is a surgical procedure aimed at closing and healing large to moderately complex wounds on the scalp, armpits, trunk, or limbs (excluding hands and feet). This procedure involves careful cleansing, aligning, and stitching of the wound to promote optimal healing and prevent infection.

Purpose

The procedure addresses large or complex wounds that cannot heal properly on their own. The primary goals are to:

1. Prevent infection.
2. Promote proper wound healing.
3. Minimize scarring.
4. Restore the function and appearance of the affected area.

Indications

• Large wounds measuring over 30 cm.
• Deep cuts with moderate complexity.
• Lacerations that involve several layers of tissue.
• Inadequately healing wounds.
• Wounds incurred from surgical incisions, accidents, or injuries.

Preparation

• Follow fasting instructions if general anesthesia is planned.
• Adjust or pause certain medications as advised by the healthcare provider.
• Complete any required diagnostic tests, such as blood work or imaging.

Procedure Description

1. Anesthesia: Local, regional, or general anesthesia is administered based on the wound's location and size.
2. Cleansing: The wound area is thoroughly cleansed to prevent infection.
3. Debridement: Dead or contaminated tissue is removed.
4. Alignment: Edges of the wound are carefully aligned.
5. Stitching: Multiple layers of the tissue are stitched together to close the wound.
   • Tools: Sterile surgical instruments, sutures, and possibly adhesive strips or staples.
6. Dressing: A sterile dressing is applied to protect the wound.

Duration

The procedure typically takes 30 minutes to 2 hours, depending on the wound's complexity.

Setting

Performed in a hospital surgical suite, outpatient clinic, or specialized surgical center.

Personnel

• Surgeons or surgical practitioners.
• Nurses and surgical assistants.
• Anesthesiologists or anesthesia nurses (if applicable).

Risks and Complications

• Infection at the wound site.
• Bleeding or hematoma formation.
• Scarring or keloid formation.
• Damage to surrounding tissues or nerves.
• Adverse reactions to anesthesia.
• Delayed or impaired wound healing.

Benefits

• Reduced risk of infection.
• Proper and prompt wound healing.
• Minimal scarring.
• Restoration of normal function and appearance.

Recovery

• Keep the wound area clean and dry.
• Follow specific wound care instructions provided by the healthcare team.
• Avoid strenuous activities that may disturb the wound.
• Attend follow-up appointments for wound assessment and suture removal if necessary.
• Healing typically takes a few weeks, with complete recovery in 4-6 weeks.

Alternatives

• Primary wound closure: For smaller or less complex wounds.
  • Pros: Faster procedure, less invasive.
  • Cons: Higher risk of improper healing in large wounds.
• Skin grafting: For extensive wounds that cannot be closed by stitching.
  • Pros: Effective for very large or complex wounds.
  • Cons: More invasive, longer recovery.

Patient Experience

• Mild discomfort during wound cleaning and stitching if under local anesthesia.
• Possible postoperative pain, managed with prescribed pain relievers.
• Mild swelling and bruising around the wound site.
• Emotional reassurance and comfort measures provided by the medical team.

By following the recommended guidelines and care instructions, patients can optimize their healing process and achieve the best possible outcome.