PREOPERATIVE DIAGNOSIS:
Abdominal wall abscess.
POSTOPERATIVE DIAGNOSIS:
Abdominal wall abscess involving urethral sling.
PROCEDURE PERFORMED:
Exploration of abdominal wall with debridement and drainage.
DESCRIPTION OF PROCEDURE:
The patient was taken to the OR. After induction of adequate general anesthesia, the patient was prepped with Betadine and draped sterilely. The abscess was slightly to the right of midline extending from across the symphysis towards the right mons and labia. The incision was made to the right of midline, carried down through subcutaneous tissue. Upon entering the cavity, foul-smelling frothy fluid exuded. Cultures for anaerobic and anaerobic were taken. There was necrotic tissue underneath. Extensive debridement was performed tunneling to the left of midline along the pubic ramus was noted and then significantly towards the labia and then also towards the right anterior superior iliac spine. The area was well debrided completely open with no residual necrotic tissue appreciated. In the base of the wound, the sling was noted. The thinned end of polypropylene was easily detached on the left side, but as well secured to the right of midline and tunneling down towards the introitus in the urethra. It was still well attached. Decision was not to more aggressively pull on this but to tag it with 0 silk suture and __________ that proper debridement of all areas were performed. The debridement extended from the skin through all subcutaneous tissue down to the pubic ramus and symphysis. The fascia was exposed. The area of debridement measured approximately 15 cm x 12 cm. The
patient’s wound was packed with Kerlix and a dry sterile dressing. She was taken to recovery room in stable condition.