Name of the Procedure:

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm

Summary

This surgical procedure involves the intermediate repair of extensive wounds (over 30.0 cm) on the face, ears, eyelids, nose, lips, and/or mucous membranes. The repair is more complex than a simple closure and may involve layered closure of deep structures.

Purpose

This procedure addresses significant, extensive wounds that cannot heal properly on their own or through simple suturing. The goals include restoring the function and appearance of the affected areas, preventing scarring, and minimizing the risk of infection.

Indications

• Deep or large wounds exceeding 30.0 cm in length
• Facial trauma or injuries
• Wounds resulting from surgeries or other medical procedures
• Conditions leading to extensive tissue loss

Preparation

• Patients may be advised to fast for 6-8 hours prior.
• Medications such as blood thinners may need to be adjusted.
• Preoperative assessments, including blood tests and imaging, to evaluate the extent of the injury and to plan the repair.

Procedure Description

1. The patient is given local or general anesthesia, depending on the extent and complexity of the wound.
2. The surgeon debrides the wound, removing any dead tissue.
3. A layered closure is performed where deeper tissues are sutured first, followed by the more superficial layers.
4. Flaps or grafts of skin may be used if necessary to cover large defects.
5. The repaired area is carefully sutured to ensure minimal scarring and to restore function and appearance.

Tools/equipment used include surgical sutures, scalpels, forceps, and possibly skin grafting materials. Local or general anesthesia is administered.

Duration

The procedure typically takes 1 to 3 hours, depending on the complexity and size of the wound.

Setting

The procedure is performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon
• Surgical nurses
• Anesthesiologist
• Sometimes a plastic or reconstructive surgeon if complex tissue repair is involved

Risks and Complications

• Infection
• Bleeding
• Scarring or poor aesthetic results
• Nerve damage
• Delayed healing or wound dehiscence (reopening of the wound)

Benefits

• Enhanced wound healing and reduced scarring
• Restoration of function and appearance of the affected areas
• Prevention of complications such as infection

Recovery

• Post-procedure care includes keeping the wound clean, applying prescribed ointments, and possibly wearing protective dressings.
• Recovery time varies but generally ranges from 1 to 3 weeks.
• Patients may have restrictions on physical activity and will need follow-up appointments to monitor healing.

Alternatives

• Simple wound closure: suitable for less extensive wounds but may not be effective for larger injuries.
• Advanced wound care with topical treatments: non-surgical options that might not provide as robust a result.
• Skin grafting alone: used for very large tissue loss but might not be as cosmetically appealing.

Patient Experience

Patients may experience discomfort, swelling, and mild pain after the procedure, which can be managed with prescribed pain medications. It's important to follow all post-operative care instructions to ensure optimal healing and outcome.