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Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex

CPT4 code

Name of the Procedure:

Repair of Laceration of Tongue, Floor of Mouth, Over 2.6 cm or Complex

Summary

This surgical procedure involves the repair of a significant or complex tear in the tongue or the floor of the mouth that is over 2.6 centimeters in length. It aims to restore normal function and promote healing by meticulously stitching the affected area.

Purpose

The procedure addresses severe cuts or tears in the tongue or the floor of the mouth, which can result from trauma or accidents. The primary goal is to ensure proper wound closure, reduce pain, prevent infection, and promote tissue healing to restore functionality and prevent complications like speech or eating difficulties.

Indications

  • Large or deep cuts in the tongue or mouth floor
  • Severe bleeding that doesn't stop with conservative measures
  • Difficulty speaking or swallowing due to the laceration
  • High risk of infection due to the wound's size or complexity

Preparation

  • The patient may need to fast for several hours before the procedure.
  • Inform your doctor of any medications you are taking; adjustments may be required.
  • Pre-procedure assessments might include blood tests or imaging studies to determine the extent of the injury.

Procedure Description

  1. The patient is typically placed under local or general anesthesia.
  2. The area around the laceration is cleaned and disinfected.
  3. The surgeon carefully examines the wound, removing any debris or non-viable tissue.
  4. Using fine sutures, the surgeon stitches the lacerated edges together, ensuring tension-free closure.
  5. Hemostasis (stopping of bleeding) is ensured throughout the procedure.
  6. The wound is then dressed, and postoperative instructions are provided.

Tools such as suturing kits, absorbable stitches, and antiseptic solutions are commonly used.

Duration

The procedure usually takes about 30 minutes to 1 hour, depending on the complexity and size of the laceration.

Setting

The repair is typically performed in a hospital operating room, outpatient clinic, or surgical center.

Personnel

  • Oral surgeon or ENT (Ear, Nose, Throat) specialist
  • Surgical nurses
  • Anesthesiologist (if general anesthesia is used)

Risks and Complications

  • Infection
  • Bleeding
  • Reopening of the wound (dehiscence)
  • Scarring
  • Numbness or altered sensation in the repaired area
  • Difficulty speaking or swallowing if complications arise

Benefits

  • Rapid and effective wound healing
  • Prevention of infections and other complications
  • Restoration of normal tongue and mouth functions, aiding in speech and swallowing
  • Reduced pain and discomfort

Recovery

  • The patient will receive instructions on oral hygiene and activity restrictions.
  • Soft or liquid diet recommendations to avoid irritating the wound.
  • Pain management, possibly including prescribed medications.
  • Follow-up appointments to monitor healing and remove any non-absorbable stitches.
  • Full recovery typically occurs within 2-4 weeks, depending on the injury's severity.

Alternatives

  • Conservative management with observation and regular cleaning for minor lacerations
  • Tissue adhesives for small and less complex wounds
  • Each alternative carries its pros and cons regarding recovery time, infection risk, and effectiveness in restoring function.

Patient Experience

  • During the procedure, if under local anesthesia, the patient might feel slight pressure but no pain.
  • Post-procedure, there may be swelling, discomfort, and mild pain managed with prescribed medications.
  • Following recovery protocols will aid in a quicker and smoother healing process, with regular follow-ups ensuring optimal outcome.

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