Name of the Procedure:

Repair, Intermediate, Wounds of Neck, Hands, Feet, and/or External Genitalia; Over 30.0 cm
Common name(s): Intermediate Repair of Extensive Wounds

Summary

This procedure involves the surgical repair of moderately complex wounds located on the neck, hands, feet, and/or external genitalia that collectively measure over 30.0 cm in length. It aims to restore the integrity of the skin and underlying tissues, promoting proper healing.

Purpose

The primary goal is to treat extensive and intermediate-level wounds that might result from trauma, surgery, or medical conditions, ensuring proper healing while minimizing scarring and functional impairment. The expected outcomes include reduced risk of infection, enhanced aesthetic appearance, and preservation of function in the affected areas.

Indications

• Extensive wounds measuring over 30.0 cm in length on the neck, hands, feet, or external genitalia
• Damaged tissues requiring layered closure for proper healing
• Patients with wounds too complex for basic suturing but not needing advanced reconstructive surgery

Preparation

• Pre-procedure fasting, typically for 6-8 hours if general anesthesia is to be used
• Adjustment or temporary cessation of certain medications, as advised by the physician
• Preoperative assessment including physical examination, wound evaluation, and sometimes imaging tests

Procedure Description

1. Assessment and Anesthesia: The wound is cleaned and assessed. Anesthesia (local or general, depending on the extent and complexity) is administered.
2. Debridement: Removing any non-viable tissue.
3. Layered Closure: Suturing the wound in multiple layers to ensure proper alignment and tension distribution, promoting optimal healing. This includes suturing the dermis and epidermis.
4. Dressing and Bandaging: Applying appropriate dressings to protect the wound and promote healing.

Tools and equipment include surgical sutures, needles, scalpels, and dressings. Anesthesia details depend on the wound's location and complexity.

Duration

The procedure typically takes between 1-2 hours, depending on the wound's extent and complexity.

Setting

The procedure is commonly performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Surgeon: Performs the wound repair.
• Nurse or Surgical Technician: Assists the surgeon.
• Anesthesiologist or Nurse Anesthetist: Manages anesthesia if required.

Risks and Complications

• Infection
• Bleeding or hematoma formation
• Scarring or keloid formation
• Nerve damage or functional impairment in the affected area
• Adverse reactions to anesthesia

Benefits

• Enhanced healing and reduced risk of infection
• Improved aesthetic outcome and reduced scarring
• Preservation or restoration of function in the affected areas
• Prompt resumption of normal activities as healing progresses

Recovery

• Post-procedure care includes keeping the wound clean and dry, and following dressing change instructions.
• Pain management typically involves over-the-counter pain relievers or prescribed medication.
• Patients are advised to avoid strenuous activities and follow specific restrictions as advised by the physician.
• Follow-up appointments ensure proper healing and address any complications.

Alternatives

• Basic wound closure for less complex wounds
• Advanced reconstructive surgery for more severe cases
• Conservative management with dressings and wound care in specific situations
• Each alternative has its own set of pros and cons, balancing between complexity, risk, healing time, and outcome.

Patient Experience

During the procedure, patients receiving local anesthesia may feel mild discomfort but will generally not experience pain. Post-procedure, pain and swelling are common but manageable with medications and rest. Patients should follow care instructions carefully to promote healing and avoid complications.