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Thyroidectomy Case Studies

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The patient is a 34-year old female with PMHx obesity, obstructive sleep apnea (OSA), Hypothyroidism, s/p R Thyroidectomy for large goiter and Grave’s disease, HTN, PSHx of
R Thyroidectomy (5/2007) and C-section of infra-umbilical longitudinal. She presented to the clinic with imaging demonstrating a large soft tissue mass arising from left iliopsoas muscle with some vessel involvement. She has 2 – 3 year history of increasing LLE edema > RLE, increasing LLQ discomfort.

After the patient’s admission on 09/14/2016, she underwent multiple procedures, e.g., RIJ central line placement, L retroperitoneal exploration, radical resection of L retroperitoneal mass, L iliac lymphadenectomy, placement of clips for tumor localization, repair of L …show more content…

However, the blister was not noted on the first wound care assessment that was done on 09/30/2016 “Patient evaluated for pressure related injury, No evidence of pressure related skin damage at present. On the center of back, skin fold, and left buttock, 1 cm, re-epithealizied, pink tissue was noted”. The patient’s initial Braden score was 9 that indicated the patient’s high risk for pressure-related skin damage. On the following skin evaluation sessions by wound care, Stage II pressure ulcers were assessed on the right buttock, induration of the left upper leg, dark discoloration from mid inner thigh to the medial aspect. Intertriginous Dermatitis (ITD) was noted in right inguinal area and had purulent drainage present. Also, several small areas of partial thickness skin loss were assessed due to moisture, pressure and sheer. Nevertheless, it was documented that overall skin wounds were resolving. On the other hand, two Stage IV pressure ulcers sites were documented on 11/11/2016: (1) left ankle distal area that was open, red, bleeding, and raw, and the medial area of the ankle that had black scab; and (2) posterior head (occiput) had a large, formerly fluid-filled blister that split open. There was purulent drainage, tunneling, and circumferential undermining that …show more content…

Pressure ulcer prevention strategies, e.g., turning and repositioning protocols were also

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