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Scalp Closure

Scalp Closure

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Preoperative Considerations

Consent:

  • Infection (especially if contaminated) and need for washouts
  • Tissue death if avulsive injury & closed under tension

Anesthesia/Positioning:

  • Supine
  • Mayfield headrest
  • Cranial drape may be useful

Other:

  • None

Armamentarium:

  • Irrigation & skin prep
  • 2-0 Vicryl
  • 3-0 skin sutures or
  • Skin stapler
  • Flat JP drain PRN
  • Drain suture (2-0 silk or nylon)
  • Bacitracin
  • Nonadherent dressing (telfa, etc.)

Technique

Postoperative Considerations

Immediate:

  • No showers

Follow Up:

  • Remove staples > POD10

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None

Specimen:***

Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

Wound was irrigated copiously with normal saline. Flat JP was placed ad the scalp was closed in layers with 2-0 vicryl and skin staples.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.

Coding

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