Elected to close the aspect of this abscess cavity

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elected to close the aspect of this abscess cavity that had been divided and closed that with a running 2-0 Vicryl and on the anterior aspect placed a Blake drain down within that and then up through the fascia and exiting in through the right lower quadrant and at this point no further abnormalities being noted we brought the colostomy out through the left abdomen without difficulty after removing a circle of skin and then making cruciate incision into the anterior fascia |8| . The opening was dilated up to 3 fingerbreadths and the distal end of the colon was brought out through that. The fascia was then closed using running #1 PDS loop from superior and one from inferior and these were approximated at the midline. The wound was then irrigated once again and iodoform gauze placed deep within the wound. It was stapled over that. The site where the cavity had been in the subcu area was opened and that was packed using just Betadine gauze well rung out. The drains were sutured with silk sutures and the wound was
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2 then covered and the stoma matured by removing the stapled end with electrocautery. It was then rosette down circumferentially using interrupted 3-0 chromic sutures. Following this, a stoma appliance was placed along with a bag and the wound was covered with sterile dressing. The patient was subsequently awakened, extubated, and taken to recovery room in stable condition |9| . Description of case is contaminated. Sponge, instrument and needle counts are correct x 2. _____________________________________________________________ |1| The postoperative diagnosis. |2| The planned procedure is Hartmann Procedure and Appendectomy. |3| Specimens sent to pathology. |4| Indication that the procedure approach is through an open incision. |5| Colon section removed. |6| Specimens sent to pathology. |7| Removal of appendix. |8| Creation of colostomy.
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  • Spring '19
  • NONE
  • Large intestine, Colon, Diverticulitis, Fístula, Appendectomy

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Christopher Reinemann
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