It was reported that the patient had vns explant surgery on (b)(6) 2014 secondary to a wound infection.Clinic and operative notes reported that the patient was admitted for surgical debridement of her vagal nerve stimulator.The patient had three weeks of erythema and swelling overlying her vagal nerve stimulator, despite antibiotics.The patient had surgical debridement on (b)(6) 2014, with pus noted overlying area."full-thickness buttonholing of the skin in the debridement" was only noted complication.The operative notes indicated that the patient¿s caregiver reported the patient had been scratching the wound and kept her left hand by the wound.They went to another hospital due to the wound problem with bubble with burst and drained pus on (b)(6) 2014.At that (b)(4) on (b)(6) /2014, there was obvious pus that was cultured.It was pan-sensitive staph and she was placed on keflex for 10 days.Once that was over, the wound bleb came up again and the wound was starting to break down and she was seen in clinic.She was started on cipro via her j-tube and then presented for definitive debridement.There is no evidence for any infection tracking up into the neck at all.The patient¿s generator and part of the proximal lead was explanted.Operative notes indicated that the wound had a very exuberant granulation tissue.Upon incising the skin, there was a gush of pus.In view of that, the surgeon felt that the wound should be debrided as there was exuberant granulation and indurated tissues, which the surgeon performed with electrocautery and in doing so was pulling the thickened scarified pocket forward and buttonholed in the left anterior axillary line.He then repaired the wounds.
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