23935 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone abscess), humerus or elbow

Name of the Procedure:

Incision, deep, with opening of bone cortex (e.g., for osteomyelitis or bone abscess), humerus or elbow

Summary

This surgical procedure involves making an incision and opening the bone cortex of the humerus or elbow to access and treat bone infections like osteomyelitis or abscesses. It's performed to remove infected or dead bone tissue and promote healing.

Purpose

Medical Condition: Osteomyelitis or bone abscess. Goals/Outcomes: The primary goal is to eradicate infection, remove necrotic bone tissue, relieve pain, and promote healing.

Indications

Symptoms/Conditions: Persistent pain, swelling, redness, fever, drainage from the affected area, or failure of prior antibiotic therapy. Patient Criteria: Patients with diagnosed osteomyelitis or bone abscess unresponsive to conservative treatments (e.g., antibiotics).

Preparation

• Pre-Procedure Instructions: Patients may need to fast for a specified period before surgery and follow specific medication adjustments as advised by their healthcare provider.
• Diagnostic Tests: Blood tests, imaging studies (e.g., X-rays, MRI, CT scans), and bone biopsy or culture to confirm infection.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A deep incision is made over the affected area.
3. Opening of Bone Cortex: The surgeon uses specialized tools to carefully open the cortex of the bone.
4. Debridement: Infected or dead bone tissue is removed.
5. Closure: The incision is closed with sutures or staples after thorough cleaning.

Tools/Equipment: Scalpels, bone cutters, surgical drills, and debridement instruments.

Duration

The procedure typically takes 1 to 2 hours, depending on the severity of the infection and the extent of debridement required.

Setting

This procedure is usually performed in a hospital or surgical center operating room.

Personnel

• Surgeon: Orthopedic or general surgeon.
• Anesthesiologist: Administers anesthesia and monitors patient vitals.
• Nurses: Assist during surgery and provide postoperative care.

Risks and Complications

• Common Risks: Infection, bleeding, and pain.
• Rare Complications: Nerve or blood vessel injury, chronic osteomyelitis, recurrence of infection, fracture, or prolonged healing time.

Benefits

• Expected Benefits: Relief of pain, eradication of infection, and improved bone healing.
• Timeframe: Benefits can be realized within weeks to months as healing progresses.

Recovery

• Post-Procedure Care: Pain management, antibiotics, and wound care.
• Recovery Time: Several weeks to months; activity restrictions and physical therapy may be required.
• Follow-Up: Regular follow-up appointments to monitor healing and detect any complications early.

Alternatives

• Other Options: Extended antibiotic therapy, needle aspiration, or less invasive surgical interventions.
• Pros and Cons: Alternatives may be less invasive but might not be effective for severe infections or extensive bone involvement.

Patient Experience

• During Procedure: The patient will be asleep or numbed, experiencing no pain during the surgery.
• After Procedure: Some pain and discomfort are expected, managed with medications. Physical therapy may be necessary to regain full function.