PREOPERATIVE DIAGNOSIS: Infected left leg below the knee amputation stump

PREOPERATIVE DIAGNOSIS: Infected left leg below the knee amputation stump. POSTOPERATIVE DIAGNOSIS: Infected left leg below the knee amputation stump. PROCEDURE: Left below the knee amputation revision. SPECIMENS: Bone and soft tissue of the left leg to Pathology. INDICATIONS: The patient is a 55-year-old male with long-standing left below-knee, low amputation. The distal end of the amputation was already hardened and scarred. There were multiple ulcerations around the lower leg, which were very difficult to heal, and which were draining. He had failed conservative management. We recommended a left below-knee amputation revision significantly away from the previous stump. We explained risks and benefits. He gave informed consent. DESCRIPTION OF PROCEDURE: The patient was taken to the holding area of the operating room and placed supine on the operating room table, and was then placed under general anesthesia. The left knee was then prepped and draped in sterile fashion. Time-out was called. We then made a fish mouth type incision, approximately 6 cm proximal to the end of the stump to avoid the scarred tissue and ulcerations, back to normal skin of the calf. We then dissected down to the fascia. We incised the fascia in line with the skin incision and incised the muscle using electrocautery. We then found the posterior vessels which we then ligated using a suture. We then irrigated with normal saline. We then used periosteal elevator to elevate the periosteum from the tibia as well as the fibula. We cut approximately 8 cm off the tibia as well as the fibula using a power saw. We beveled the edges to make them smooth. We then irrigated well with normal saline. We released the tourniquet and coagulated all bleeders with electrocautery. We then placed a Hemovac drain. We then closed the fascia using #1 Vicryl, the subcutaneous layer with 2-0 Vicryl, and the skin with staples. Wound was dressed using antibiotic ointment, Xeroform, 4×4s. The patient was placed in a long leg splint in full extension. The patient was awakened and discharged to PACU. Assign ICD-10-PCS code(s) to the following case study: