Name of the Procedure:

Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm
Common Name(s): Complex Wound Repair, Deep Layer Wound Closure

Summary

This procedure involves the surgical repair of complex wounds on the scalp, arms, and/or legs that are between 2.6 cm and 7.5 cm in length. The wounds may have multiple layers that need to be meticulously closed to ensure proper healing and functional restoration.

Purpose

This procedure addresses significant lacerations, traumatic injuries, or complex surgical wounds that are too deep or intricate to heal properly with simple closures. The goal is to ensure functional recovery, minimize scarring, and prevent infection.

Indications

• Deep lacerations or cuts
• Traumatic injuries with exposed underlying structures
• Surgical incisions that require complex closure
• Patient has risk factors that impede proper wound healing (e.g., diabetes, poor circulation)

Preparation

• Follow fasting instructions if general anesthesia is required
• Cease certain medications as advised by the physician
• Complete diagnostics such as blood tests or imaging, if recommended

Procedure Description

1. Anesthesia: Local anesthesia is commonly used; general anesthesia may be used for larger or more complex repairs.
2. Wound Cleaning: The wound is thoroughly cleaned to remove debris and reduce infection risk.
3. Layered Closure: Different layers of the wound are closed starting from the deepest layers using absorbable sutures; superficial layers are closed last.
4. Skin Closure: Non-absorbable sutures or staples may be used for the skin.
5. Dressing: Sterile dressings are applied to protect the wound.

Duration

Typically takes 30 minutes to 2 hours, depending on the complexity and size of the wound.

Setting

Usually performed in an outpatient clinic, surgical center, or hospital setting.

Personnel

• Surgeon or specialized wound care physician
• Surgical nurse
• Anesthesiologist or nurse anesthetist, if sedation is used

Risks and Complications

• Infection
• Bleeding
• Scarring
• Damage to underlying structures (nerves, tendons)
• Wound dehiscence (reopening)
• Allergic reactions to anesthesia

Benefits

• Enhanced healing and reduced risk of infection
• Minimization of scarring
• Restoration of function and appearance
• Prompt and effective wound closure

Recovery

• Keep the wound clean and dry
• Follow wound care instructions provided by the healthcare provider
• Limit physical activity based on doctor's advice
• Attend follow-up appointments for suture removal and checking wound healing
• Recovery typically takes 2-4 weeks

Alternatives

• Simple wound closure (may be inadequate for complex wounds)
• Non-surgical wound care (risk of improper healing)
• Skin grafts or flaps for extensive tissue loss

Patient Experience

During the procedure, patients may only feel minor discomfort due to the local anesthesia. Post-procedure, mild to moderate pain can be expected, which can be managed by prescribed pain medications. Some swelling and redness are common, and proper wound care and rest will aid in the recovery.