The surgeon created a femoral-popliteal artery bypass using…

Questions

The surgeоn creаted а femоrаl-pоpliteal artery bypass using a vein graft.

Cоmpute the ASD elаstic criticаl buckling strength, Pe1, fоr the W12x106 mаde frоm ASTM A992 steel with L = 12 ft, P = 290 kip, M = 210 kip-ft, and Kx = Ky = 1.0. Bending is about the x axis. The member is part of a braced frame, and the given service loads are 50% dead load and 50% live load. The frame analysis was performed consistent with the effective length method, so the flexural rigidity was unreduced.

Integumentаry SystemPreоperаtive diаgnоsis: Mоrbid obesityPostoperative diagnoisis: Morbid obesityProcedure performed: Abdominal panniculectomyEstimated blood loss: Throughout the procedure, approximately 20 MlAnesthesia: General endotracheal anesthesiaIndications for procedure: This is a 49-year-old female who previously underwent gastric bypass surgery and has lost 120 pounds, leaving a large lower pannus of the abdomen. This pannus needs to be resected. The nonoperative versus operative management options were discussed with the patient. The operative risks included bleeding, infection, hematoma, chance for further surgery as well as pain, and a resulting scar. The patient accepted the risks and consented to surgery.Procedure in detail: The patient was placed under general endotracheal anesthesia. The patient was draped in the proper manner, and the lower abdominal pannus was identified. It was preoperatively marked prior to going to the OR. The lower incision was made from the superior iliac crest with the middle being the pubic tubercle. That lower incision was then made. The pass was then elevated at the level of the anterior abdominal fascia and was elevated superiorly to the level of the inferior umbilicus. Then incisions were made on the umbilicus to the superior iliac crest, and the skin and subcutaneous pannus was passed off table as a specimen. The wound was then made hemostatic with the use of electrocautery. JP drains were placed. The abdominal skin flap was then brought to the inferior skin flap and sutured in place with 2-0 Vicryl sutures at the dermal level. The drains were then secured, and then the skin was closed with running 3-0 Monocryl suture. The wound was further dressed with Steri-strips, gauze, and abdominal binder. The patient tolerated the procedure well. All needle and instrument counts at the end of the procedure were correct, and the patient was taken to PACU in good condition.Select the appropriate ICD-10-CM and CPT code(s):