[Expert Solution]: Case 3: Operative Report PREOPERATIVE…

Case 3: Operative Report PREOPERATIVE DIAGNOSIS: Scrotal abscess POSTOPERATIVE DIAGNOSIS: Scrotal abscess PROCEDURE: Debridement of scrotal abscess and scrotal exploration INDICATIONS: This male with Type 2 diabetes, who has no prior history of recurrent scrotal and perirectal abscesses, now requires debridement and wound care. He developed some scrotal pain and swelling several days ago. On CT scan, there was concern for scrotal abscess versus early Fournier’s gangrene. His dose of Zosyn was running just prior to the start of the case. SPECIMENS: Aerobic and anaerobic culture from scrotal abscess DESCRIPTION OF PROCEDURE: The patient has been identified and brought to the operative suite. There, general anesthesia was successfully induced. The patient was then placed in dorsal lithotomy position and prepped and draped in the usual sterile fashion. On exam, he had a fluctuant induration of his left hemiscrotum. This was incised with a 11 blade. There was immediate drainage of gross purulent fluid. A culture swab was obtained and sent for wound culture. Next, we used Mayo scissors to excise an approximately 2 × 2 centimeter area above the abscess. This tissue appeared necrotic. We then continued our dissection down approximately a centimeter and a half to about 2 cm. We sharply debrided all necrotic appearing tissue with the Mayo scissors until there was healthy bleeding tissue. We aggressively probed the wound to ensure that there was no tracking. There is also an area of fluctuance at the inferior portion of the left hemiscrotum that was concerning for a second possible abscess pocket. This was incised through the dartos tissue. However, no abscess pocket was encountered. This was simply likely reactive edema. The wound did not appear infected, so we opted to close it with several interrupted 3-0 nylon sutures. Next, we then turned our attention to the debrided abscess. We copiously irrigated this. We used pinpoint electrocautery to provide hemostasis and packed the wound with Nu Gauze. We then performed a digital rectal exam to ensure that there was no fluctuance in the rectum or perineum, and none was found. We then washed the genitals, covered the Nu Gauze with kerlix fluffs and applied mesh underwear. All instrument counts were correct. The patient tolerated the procedure well and was transported to recovery room in stable condition. What are the 3 ICD-10-PCS codes for this case?