Name of the Procedure:

Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional.

Summary

This surgical procedure involves the removal of damaged or scarred tissue from open wounds, burns, or contractures. Additional 100 square centimeters of tissue may also be addressed for extensive areas. The goal is to prepare the site for further surgical interventions, such as grafting or reconstruction.

Purpose

The procedure aims to treat severe burns, extensive scars, or contractures that restrict movement or cause cosmetic concerns. It prepares the affected area for further treatment, improves functionality, and enhances the aesthetic appearance.

Indications

• Severe burns with eschar that need surgical intervention.
• Extensive scarring that causes mobility or functional issues.
• Scar contractures, which limit movement or cause discomfort.
• Open wounds that require surgical preparation for healing or grafting.

Preparation

• The patient may be instructed to fast for several hours before the procedure.
• Medication adjustments, especially blood thinners, might be necessary.
• Pre-procedural assessments may include blood tests, imaging studies (like X-rays or MRIs), and physical examination.

Procedure Description

1. The patient is positioned and the surgical area is sterilized.
2. Anesthesia (local or general) is administered to ensure patient comfort.
3. The surgeon makes incisions to remove damaged tissue, scar, or burn eschar.
4. Subcutaneous tissues are also addressed if necessary.
5. If releasing a contracture, the surgeon will carefully excise and possibly use techniques to release tight tissues.
6. Hemostasis is ensured, and the surgical site may be prepared for further grafting or closure.
7. Dressings are applied to protect the surgical site.

Duration

The procedure typically takes 1 to 2 hours, depending on the extent of the area being treated.

Setting

This procedure is usually performed in a hospital surgical suite or a specialized outpatient surgical center.

Personnel

• Surgeons specializing in plastic, reconstructive, or burn surgery.
• Surgical nurses and assistants to assist with the procedure.
• An anesthesiologist to manage anesthesia.

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Delayed wound healing or poor cosmetic outcome.
• Scar formation or recurrence of contracture.
• Adverse reactions to anesthesia.

Benefits

• Improved functionality and range of motion.
• Enhanced cosmetic appearance.
• Reduced discomfort and better quality of life.
• Facilitates further surgical interventions like grafting.

Recovery

• Patients will receive instructions on caring for the surgical site, including wound care and dressing changes.
• Pain management involves medications as prescribed by the healthcare provider.
• Initial recovery may take a few weeks, with complete healing taking several months.
• Follow-up appointments are essential to monitor healing and progress.
• Activity restrictions might be necessary to prevent strain on the surgical area.

Alternatives

• Non-surgical treatments like laser therapy or steroid injections, though they may be less effective for severe cases.
• Physical therapy to manage minor contractures or scarring without surgical intervention.
• Pros and cons should be discussed with the healthcare provider to choose the best approach for each patient.

Patient Experience

• The patient will feel minimal discomfort during the procedure due to anesthesia.
• Post-surgical pain and swelling are expected, managed with medication.
• Some discomfort and restricted movement may occur during the initial recovery period.
• Comfort measures include appropriate pain management and following post-operative care instructions.