DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Severe ischemia, left lower extremity.
POSTOPERATIVE DIAGNOSIS: Severe ischemia, left lower extremity.
OPERATION PERFORMED: Left above knee amputation.
SURGEON: John Doe, MD
ANESTHESIA: General anesthesia.
DESCRIPTION OF OPERATION: The patient was brought to the operating room and was placed in the supine position. General endotracheal anesthesia was induced. The left lower extremity was prepped and draped in the usual sterile manner. Then, curved incisions were made just above the knee, both anteriorly and posteriorly. These had meeting at the medial and lateral edges. Subcutaneous tissues and fascia were incised again using cautery extensively. Then, quadriceps muscle was transected using cautery again. Femoral vessels were identified and were dissected and separated. Femoral artery and femoral veins were individually clamped, transected, and proximal ends were suture ligated with 2-0 silk stitches. There was thrombus from popliteal vein graft, which was also transected and ligated with 2-0 silk stitches. Then, all the muscles were transected, and the sciatic nerve was transected and tied with the 2-0 Vicryl tie and allowed to retract. The femur itself was cleaned. Using an electric saw, we transected the femur. Then, bone wax was applied to prevent bleeding from the marrow. Then, muscles were closed in front of the femur with interrupted 2-0 Vicryl sutures. Subcutaneous tissues were closed with two layers of interrupted 2-0 Vicryl sutures. Then, the skin was closed with staples. Sterile dressings were applied, and the patient was transferred out of the operating room in stable condition.
DATE OF OPERATION: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Ischemic gangrene and rest pain, right foot.
POSTOPERATIVE DIAGNOSIS: Ischemic gangrene and rest pain, right foot.
OPERATION PERFORMED: Right above knee amputation.
SURGEON: John Doe, MD
ANESTHESIA: General endotracheal.
DESCRIPTION OF OPERATION: The patient was brought to the operating room and placed on the operating table in the supine position. After adequate induction of anesthesia, the right leg was prepped and draped in sterile fashion. The intended incisions were marked out on the skin just above the patella with an anterior and posterior flap configuration. An incision was then made along these marked lines and continued through the subcutaneous tissue into the fascia circumferentially around the leg. The muscles in the anterior compartment were then divided down to the femur. The femur was mobilized using a periosteal elevator and divided using an oscillating saw. The muscles of the posterior and medial compartment were then divided using an amputation knife to complete the amputation. Specimen was passed off the field. The superficial femoral vein and artery were clamped individually and oversewn with 3-0 Prolene. The sciatic nerve was identified and mobilized. It was suture ligated with 3-0 chromic for vascular control. Multiple other pulsatile bleeding sites were controlled with electrocautery and 3-0 chromic sutures. Hemostasis was obtained with gentle pressure. The bone was beveled anteriorly and smoothed. The marrow was packed with bone wax. The anterior and posterior fascias were then reapproximated to each other using interrupted 2-0 Vicryl sutures. The skin was closed using staples. A clean, sterile, dry compression dressing was placed. The patient was transferred to the recovery room in stable condition having tolerated the procedure well.
