Outpatient Surgery Magazine - Subscribers

Clear Cut - July 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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1 2 1 J U LY 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T including mastectomies, open appendectomies and even minor exci- sion wounds. Here's how to do it: • Begin irrigation after closure of the fascia. • Make sure the head of the operating table is elevated and that you have a basin at the lower end of the wound. • Use voluminous amounts of saline (typically 2 to 5 liters) and vig- orously finger massage the wound margins. • To ensure that all devitalized and loose fatty tissue is removed, continue irrigating until no loose fat tissue floods over the inferior aspect of the incision. The technique adds little time to the procedure, it's inexpensive, and it works. My partner and I have used vigorous irrigation of the subcu- taneous tissue to remove devitalized fat in 600 open vertical banded gastroplasties and haven't had a single major wound infection. I have no doubt that the time we've invested has decreased the cost of care by preventing potentially costly complications. OSM Dr. Biesecker (vivngar@aol.com) specializes in general surgery at High Point (N.C.) Regional Hospital.

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