Query Assignment: Research how to create a non-leading query on…

Question Query Assignment: Research how to create a non-leading query on…  Query Assignment: Research how to create a non-leading query onthis topic. Don’t forget to include options for your doctor including the option for free text or “other”.OPERATIVE REPORT:PREOPERATIVE DIAGNOSIS: Open wound left lower extremity status post fasciotomies of the left lowerextremity for compartment syndrome status post external fixator for left tibial plateau fracture.POSTOPERATIVE DIAGNOSIS: Open wound left lower extremity status post fasciotomies of the left lowerextremity for compartment syndrome status post external fixator for left tibial plateau fracture.PROCEDURE PERFORMED: Irrigation and debridement of the left lower extremity down to muscle ofthe medial and lateral wounds, both greater than 10 cm each.ANESTHESIA TYPE: General.ESTIMATED BLOOD LOSS: Less than 10 mLCOMPLICATIONS: None.INDICATIONS FOR SURGERY: The patient is a 59-year-old male with the above diagnosis. Thepatient had initial application of external fixator and fasciotomies performed by my partner onNovember 23rd. The patient had open wounds, initially had application of a wound VAC with the intentto bring him back to the operating room for repeat I and D, possible ORIF, possible wound closure.Preoperatively, the patient’s leg had too much soft tissue swelling. He did not have a positive wrinklesign, so the soft tissues were too swollen to proceed with definitive fixation, so the decision formaintaining the fixator and just doing irrigation and debridement along with possible wound closurewas made at that time. Risks and benefits were explained to the patient. He made an informed decisionto proceed with the above procedure.PROCEDURE:The patient was seen preoperatively. The left lower extremity was marked. He wasbrought in the operating room, placed on the operating table, given a general anesthetic. The left lowerextremity was then thoroughly prepped and draped in standard orthopedic fashion. Once that wasdone, universal protocol of a time-out was taken to confirm that the left lower extremity was the correctoperative site. Once that was done, 3 liters of lactated Ringer’s laced with bacitracin was used for bothmedial and lateral wounds. Any nonviable or necrotic subcutaneous tissue was debrided down fromboth wounds. There was not an excessive amount of bleeding, and the wounds were closed withinterrupted subcutaneous 2-0 Vicryl for the subcutaneous layer and a running 4-0 V-Loc for the skin.Wounds were then dressed with Steri-Strips, Xeroform, 4 × 4s and Ace wrap. Xeroform was also placedaround the pin sites for the external fixator which was also prepped out from the procedure. The patientwas also noted to have some fracture blisters and several abrasions to the skin. Once the leg wasdressed, the patient was extubated and transferred to postanesthesia recovery unit in stable condition.All sponge and sharp counts were correct.The patient received preoperative antibiotics and will receive postoperative antibiotics. He isnonweightbearing. He will be placed back on his anticoagulant treatment, most likely Lovenox, for DVTprophylaxis and he will be discharged at the discretion of Trauma Service to follow up in the office forreevaluation and determine when definitive fixation will be performed.                                Health Science Science Nursing HIT 215 Share QuestionEmailCopy link Comments (0)