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Repair of syndactyly (web finger) each web space; with skin flaps and grafts
CPT4 code
Name of the Procedure:
Repair of Syndactyly (Web Finger) Each Web Space; with Skin Flaps and Grafts
Summary
The repair of syndactyly entails separating fused fingers and reconstructing the area between them using skin flaps and grafts. This helps restore function and appearance.
Purpose
This procedure addresses congenital syndactyly, where fingers are webbed or fused together. The goal is to separate the fingers to improve hand function and appearance.
Indications
- Fused fingers at birth (congenital syndactyly)
- Significant impairment in hand function
- Aesthetic concerns or deformities
Preparation
- Fasting for 6-8 hours before surgery
- Adjustments in current medications based on doctor's advice
- Pre-operative physical examination and possibly x-rays or other imaging
Procedure Description
- Anesthesia: The patient is put under general anesthesia.
- Incisions: Surgical cuts are made to separate the fused fingers.
- Skin Flaps and Grafts: Tissue is mobilized from the surrounding area or other parts of the body to cover the newly separated fingers.
- Suturing: The skin flaps and grafts are carefully sutured into place.
- Dressing: The hands are dressed to protect the surgical sites.
Duration
Typically, the procedure takes 2-4 hours, depending on the complexity.
Setting
The procedure is performed in a hospital or specialized surgical center.
Personnel
- Pediatric or plastic surgeon specializing in hand surgery
- Anesthesiologist
- Operating room nurses
- Surgical technicians
Risks and Complications
- Infection
- Bleeding
- Scarring
- Graft failure
- Nerve damage
- Need for additional surgeries
Benefits
- Improved hand function
- Enhanced appearance
- Better quality of life
- The benefits are often noticeable immediately, though full recovery takes longer.
Recovery
- Postoperative instructions include keeping the hand elevated and clean.
- Splints may be used to protect the repairs.
- Follow-up appointments are necessary to monitor healing.
- Full recovery typically takes several weeks to months, with possible physical therapy.
Alternatives
- Non-surgical observation if the syndactyly does not impair function
- Other types of reconstructive surgeries
- Pros and cons: Non-surgical may not improve function, other surgeries might involve different techniques with similar or varying outcomes.
Patient Experience
- During the procedure: No sensation due to general anesthesia.
- After the procedure: Pain managed with medications, swelling, limited hand movement temporarily, and instructions to follow for wound care and activity restrictions.
- Gradual improvement in hand function and appearance over the recovery period.