Name of the Procedure:

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm

Summary

This procedure involves the intermediate repair of wounds on the face, ears, eyelids, nose, lips, and mucous membranes that measure between 12.6 cm and 20.0 cm. "Intermediate" repair means it requires layered closure of one or more deeper structures like subcutaneous tissue and non-muscle fascia.

Purpose

The procedure addresses moderate to complex cuts or lacerations on facial and mucosal areas. The goal is to restore the structure and function of the affected areas, minimize scarring, and prevent complications like infection.

Indications

• Moderate to deep facial lacerations measuring between 12.6 cm and 20.0 cm.
• Cuts involving multiple layers of tissue.
• Wounds with a high risk of infection if not properly closed.
• Situations where aesthetic outcomes are crucial.

Preparation

• Patients may be advised to fast for several hours before the procedure if general anesthesia is planned.
• Medication adjustments might be required, particularly blood thinners and other medications affecting healing.
• Diagnostic tests such as blood work and imaging might be necessary to assess the extent of the injury.

Procedure Description

1. Anesthesia: Local anesthesia to numb the area; general anesthesia if extensive repair is required.
2. Cleaning and Debridement: The wound is cleaned, and any foreign material or dead tissue is removed.
3. Layered Closure: Sutures are placed in layers to close subcutaneous tissues, followed by suturing the skin.
4. Dressing: A sterile dressing is applied to protect the wound.

Tools used include sutures, needle holders, forceps, and possibly dermal adhesives or skin tapes.

Duration

The procedure typically lasts between 45 minutes to 2 hours, depending on the complexity and size of the wound.

Setting

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

Personnel

• A surgeon or a qualified physician.
• Surgical nurses.
• An anesthesiologist (if general anesthesia is used).

Risks and Complications

• Infection
• Scarring
• Bleeding
• Nerve damage
• Wound dehiscence (reopening of the wound)
• Allergic reaction to anesthesia

Benefits

• Enhanced wound healing and reduced risk of infection.
• Improved cosmetic and functional outcomes.
• Faster recovery compared to more extensive surgeries.

Recovery

• Keep the wound clean and dry.
• Follow prescribed care instructions and medications.
• Expect mild swelling and discomfort for a few days.
• Stitches generally removed in 5 to 10 days.
• Full recovery within 2 to 3 weeks, with follow-up appointments as needed.

Alternatives

• Primary closure without layered sutures, albeit with higher risk of complications.
• Delayed primary closure for contaminated wounds.
• Conservative management with wound care, though less effective for deep cuts.

Patient Experience

During the procedure, patients numbed with local anesthesia will feel pressure but not pain. Post-procedure, mild to moderate pain is common and managed with prescribed pain relief medications. Instructions will include activities to avoid and signs of complications to watch for, such as increased redness, swelling, or discharge from the wound.