Sacral/Buttock Debridement
This intervention involves the sharp excision of necrotic, infected, or non-viable integumentary and soft tissue from the sacrococcygeal region. The goal is to reach healthy, vascularized margins to promote secondary intention healing or prepare the site for future reconstructive grafting.
Surgical instruments
10 on this table — tap a photo to zoom, the name for its full card.
The case
Spark notes
The 30-second rundown — scan this outside the room.
- Prepare the sterile surgical field and necessary instruments, including a scalpel with a 15 blade loaded on a #3 knife handle.
- Use curved mayo scissors or metzenbaums with rat tooth or DeBakey forceps to cut and scrape away dead tissue. Use hemostats or a tonsil to control bleeding.
- Thoroughly irrigate the site with sterile solution using a sterile syringe or bulb syringe.
- Pack the site with sterile gauze or suture the wound closed with a needle holder and suture material depending on the size of the wound.
Walkthrough
What the surgeon does — and what to have in your hand before they ask.
Removing Dead Tissue
The surgeon will begin by cutting and scraping away any dead tissue using curved mayo scissors or metzenbaums with rat tooth or DeBakey forceps. These instruments will help to remove any damaged tissue without causing further injury to the surrounding healthy tissue. A hemostat or a tonsil may also be required to control bleeding during this step.
Irrigating the Site
After removing all of the infected tissue, the surgical site will need to be thoroughly irrigated to remove any remaining debris or bacteria. The irrigation solution should be sterile, and the irrigation should be done using a sterile syringe or bulb syringe to minimize the risk of infection.
Packing the Site or Closing the Wound
Depending on the size of the surgical site, the surgeon may choose to either pack the area with sterile gauze or suture the wound closed. If the wound is packed with gauze, it should be done with sterile gloves and packed tightly enough to prevent any dead space or pockets from forming. If the wound is sutured closed, the surgeon will need a needle holder and suture material to close the incision.
Tips and tricks
The smell during Sacral/Buttock Debridement surgeries can be quite strong, so it may be helpful to apply a small amount of peppermint oil or mastisol to the outside of your mask to mask the odor.
Always have culture tubes available in case a sample needs to be taken during the procedure.
If the surgical site will be packed with gauze instead of sutured closed, it is common to soak the gauze in Betadine solution prior to use.
When setting up for the surgery, consider whether you prefer to work off of a back table or drape a mayo stand. It's a personal preference, but using a back table may be more efficient in smaller ORs.
Add your table
Every surgeon runs it a little differently. Submissions stay private, are reviewed by our team, and accepted contributions earn a credit in the contributor list.