Home

Incision and drainage معنى

Incision & Drainage - Coding Master

An incision and drainage procedure as the name implies involves making an incision into the body and draining fluid from the body. This fluid drained can be an area of infection such as an abscess or it may be an area of hematoma or seroma When an incision and drainage (I&D) procedure is planned to help relieve the discomfort of an abscess, it is often difficult to achieve adequate pain control through the administration of local anesthetics, primarily because of the change in tissue pH brought about by the formation of purulent material within the infected area Incision and drainage and clinical lancing are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus. It is performed by treating the area with an antiseptic , such as iodine -based solution, and then making a small incision to puncture the skin using a sterile instrument such as a sharp needle, a pointed scalpel or a lancet Incision and Drainage. Incision and drainage (I&D) is a widely used procedure in various care settings, including emergency departments and outpatient clinics. It is the primary treatment for skin and soft tissue abscesses, with or without adjunctive antibiotic therapy. This activity will focus specifically on its use Sometimes, a small piece of tubing is left in the cut to let drainage come out. This drain may fall out by itself. If not, it will be taken out by your doctor at your next appointment. Incision. Do not put any medicines or creams on your child's cut. This cut is also called an incision. This incision will need to be cleaned well

Incision and drainage is a procedure to drain a pocket of fluid, such as pus or blood. How do I prepare for incision and drainage? Arrange to have someone drive you home after the procedure The present study was carried out to compare the conventional method of incision and drainage with incision and drainage with primary closure of the wounds in acute abscesses with regards to wound. Instead, visit your dermatologist for a simple and effective procedure known as incision and drainage (I&D). An abscess will most often not heal on its own or even with antibiotics, and the pus usually needs to be drained to promote healing

An incision was made with a #15 blade transversally across the area of the palpable fluctuance and where there was noted to be drainage through the skin. Thick malodorous purulence was encountered and this was completely drained Incision and drainage is a procedure to drain a pocket of fluid, such as pus or blood. How to prepare for incision and drainage: Arrange to have someone drive you home after the procedure. Tell your healthcare provider about all medicines you currently take. He or she will tell you if you need to stop taking any medicine before the procedure. Chapter 37 Incision and Drainage Liam C. Holtzman, Eveline Hitti and Jeffrey Harrow Incision and drainage (I&D) procedures in the emergency department (ED) are most commonly performed for soft tissue abscesses (Fig. 37-1).1,2 The total number of ED visits increased from 90 million to 115 million over a 10-year period, with visits for abscess-related complaint Drainage process in which a predetermined quantity of waste is transported in a pipe under pressure lower than atmospheric pressure from a starting tank for temporary storage to a destination storage tank by the admission of air at atmospheric pressure into the pipe close to the starting tank for temporary storage when this starting tank is filled to a given level, characterised in that air at atmospheric pressure is also admitted at least at a point which is remote from the starting tank.

Incision and Drainage - an overview ScienceDirect Topic

  1. Abscess Incision and Drainage (I+D)..!!Patient had cysts on back growing for some months,it then got extremely painful, bigger and red over a 2 wks period...... Abscess Incision and Drainage (I+D.
  2. Thank you for your response! My thought is if you I&D an abscess... to relieve pressure and pain the patient is experiencing and collect a culture. the qualifier for the procedure should be Z. This makes a big difference between a medical and surgical DRG. Only one incision is made.... Patient already on antibiotics prior to I&D
  3. or surgical procedures to release pus or pressure built up under the skin, such as from an abscess or boil.It is performed by treating the area with an antiseptic, such as iodine based solution, and then making a small incision to puncture the skin using a sterile instrument such as a sharp needle, a pointed scalpel or a lancet
  4. The process featured in a lot of Dr. Lee's videos is called an incision and drainage (I&D), a procedure in which the doctor cuts the offending area open, cleans everything out, and preps the area for healing with packing and/or sutures
  5. incision & drainage: Surgery The incising of an abscess to allow pus to drai
  6. Drain left for at least 24 hours. Dressing: Dressing is always applied over the site of incision taken extraorally without pressure. Purpose of keeping the drain in such incision: The purpose of this drain is to allow the discharge of tissue fluids and pus from the wound by keeping the drainage tube patent
  7. Just a tinny little bit of oozin

drain n. noun: Refers to person, place, thing, quality, etc. (medicine: device to draw off fluid) (في الطب: أداة لنزح أو صرف سائل) مَنْزَح. The doctors fitted Chris with a drain to draw the fluid off his lungs. drain [sth] ⇒ vtr. transitive verb: Verb taking a direct object--for example, Say something. She. Once you experience symptoms of abscess and receive a diagnosis, your dentist may recommend surgical incision and drainage. Dental abscess drainage is a common treatment for dental abscess. It removes the infected material and allows the abscess to be thoroughly cleaned and treated. There are three steps to dental incision and drainage Incision and Drainage of Cutaneous Abscesses. Watch later. Share. Copy link. Info. Shopping. Tap to unmute. If playback doesn't begin shortly, try restarting your device. Up next in 8 INCISION AND DRAINAGE ABSCESS | CYST 2020 - YouTube. Watch later. Share. Copy link. Info. Shopping. Tap to unmute. If playback doesn't begin shortly, try restarting your device. You're signed out Incision and drainage involves the following: cleansing of the skin over the abscess with an antiseptic agent. freezing of the area using a local anesthetic. making an incision over the top of the incision from top to bottom. expressing the abscess to encourage drainage. exploring the abscess to ensure we have gotten all of the infected.

Incision and drainage - Wikipedi

In fact, incision and drainage is not commonly performed for treatment of paronychia in the foot without avulsion of the toenail. This procedure usually effectively drains any associated infection. Therefore, the provider who performs this procedure to address a localized infection should bill the appropriate code 11730, and not one for an incision and drainage service The LOOP technique: a novel incision and drainage technique in the treatment of skin abscesses in a pediatric ED. Am J Emerg Med 2015; 33:271. Özturan İU, Doğan NÖ, Karakayalı O, et al. Comparison of loop and primary incision & drainage techniques in adult patients with cutaneous abscess: A preliminary, randomized clinical trial Incision and drainage (I&D) is most often necessary for an abscess, boil, or wound. An abscess is a painful infection that occurs when the oil or sweat glands become obstructed, trapping bacteria beneath the skin. Inflammation and infection result, which leads many to the hospital ER. Incision and drainage, however, is actually a simple.

Incision and drainage (I&D) is a simple in-office procedure that in most cases is curative for superficial abscesses and related infections including uncomplicated methicillin-resistant Staphylococcus aureus (MRSA) abscesses. Commonly, patients will present with the acute onset of localized pain, swelling, and erythema indicating abscess formation (Figure 17-1) Fill the syringe with soapy water. Squirt the soapy water into the incision. Allow the water to drain out. Repeat this 2-3 times a day or whenever your child poops. You will still need to soak the child in a bath twice day. Watch your child for signs of infection. Look at your child's incision each day. Call your doctor if

Incision and drainage is a procedure to drain a pocket of fluid, such as pus or blood. How do I prepare for incision and drainage? Arrange to have someone drive you home after the procedure. Tell your healthcare provider about all medicines you currently take. He or she will tell you if you need to stop taking any medicine before the procedure. INCISION AND DRAINAGE. DR.MATHISEKARAN.T. TMCH,Thanjavur ABSCESS Abscesses are localized infections of tissue marked by a collection of pus surrounded by inflamed tissue. Found in any area of the body,most abscesses presenting for urgent attention are found on the extremities, buttocks, breast, perianal area, or from a hair follicle Incision and Drainage. The patient was correctly identified, brought back to the operating room and transferred to the operating table. General anesthesia was administered. The patient was positioned []. Their [] was prepped and draped in sterile fashion. A time out procedure was performed Instead, visit your dermatologist for a simple and effective procedure known as incision and drainage (I&D). 1 . An abscess will most often not heal on its own or even with antibiotics, and the pus usually needs to be drained to promote healing. An I&D, usually performed right in your doctor's office, can achieve this safely and comfortably Furuncle of central face (risk of septic phlebitis) Infection below bridge of nose and above lip. Treat with antibiotics and warm compresses. IV. Precautions. Avoid incision deeper than floor of lesion. Wear protective eyewear during Incision and Drainage (e.g. Face Mask with eyeshield) Follow closely and wound culture higher risk patients

Incision and drainage of left upper extremity soft tissue abscess. SURGEON: John Doe, MD. ANESTHESIA: General LMA. DESCRIPTION OF PROCEDURE: The patient was prepped and draped. We identified the old incision; this was elongated. Loculations of fibrous tissue were broken up. An inflammatory rind was identified and this was sent for culture drainage system n noun: Refers to person, place, thing, quality, etc. (for removing excess water) شبكة تصريف مياه : They're laying down a drainage system in the lower field. هل هناك شيء مهم ناقص؟ أبلغ عن خطأ أو اقترح تحسينًا Specifications :-. Incision & Drainage Set consists of instruments made of High Grade Stainless Steel. Incision and drainage and clinical lancing are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus. It is performed by treating the area with an antiseptic.

Incision and Drainage. Make a linear incision across the diameter of the fluctuant area, ensuring appropriate depth to have reached the cavity of purulence as in Figure 4 and 5. It's also important to ensure the length of the incision will allow adequate drainage and room to use hemostats; this is typically between 2/3rd to the full length of. Incision and drainage is a covered procedure for treating abscesses. Incision and drainage of non-abscess fluid collections is covered when medically necessary due to pain or inflammation. Repeated incision and drainage is not expected, however, in the case of hidradenitis, this may be experienced but the provider must document the reason that. In a study by Wang et al., oxacillin, with or without incision and drainage, was effective in 16 (89%) of 18 children with CA-MRSA SSTIs, even in a case with high-level oxacillin resistance (MIC [greater than or equal to] 8 [micro]g/mL) (4) Abscess incision and drainage. You can get an abscess anywhere in your body, which can cause a painful lump and can make you feel unwell. What is an abscess? An abscess is a collection of pus surrounded by a wall of tissue. It causes a painful lump and can make you feel unwell. An abscess happens when your body tries to control infection by.

Incision and Drainage - PubMe

The process featured in a lot of Dr. Lee's videos is called an incision and drainage (I&D), a procedure in which the doctor cuts the offending area open, cleans everything out, and preps the area for healing with packing and/or sutures. Perhaps the queen mother of all zits is the pilonidal cyst, a collection of debris at the top of the. 1) the land on which the building has been elevated, the foundations, the main walls, the roofs and the terraced roofs, the stairways, the main access gates, the lobbies, the passages, the porches, the courtyards, and all the building elements needed for the common use; 2) the premises for the concierge desk and quarters, the laundry, the central heating facilities, drying rooms and other. Abscess incision and drainage is a relatively simple procedure that is commonly performed at our first-class facilities by highly experienced general surgeons. Ramsay Care Health UK is a leading provider of private healthcare in England and has a network of over 35 UK hospitals , all of which are regulated and inspected by the Care Quality. If the infection progresses to a frank abscess, an incision and drainage is performed. drbustillo.com Si la infección em peora y se pr od uce un absceso, entonces se lle va a c abo un a incisión y drenaje Post Incision and Drainage (I&D first time) So I'm about 10 days in after having a pilonidal abscess drained. Surgeon left the wound open with instructions to unpack, clean, and repack with iodoform gauze at least once per day. My father is assisting with the re-packing of the open wound

Incision and drainage University of Iowa Stead Family

Invasive interventional procedure s 0184t excision of rectal tumor surgery colon and rectal diagnosis coding for pilonidal cysts cpt code surgery Cpt Code SurgeryOutpatient Surgical Procedures Site Of Service Cpt Hcpcs CodeCpt Codes Requiring Prior AuthorizationFinal Examination With S And RationalesAvailable Cpt Codes By Area And TypeRopriate Cpt Codes For Pas Claims Final 2005 EmednyCpt. The next series of codes for incision and drainage procedures CPT 10080-10081 refers to incision and drainage of pilonidal cyst; simple or complicated. In this procedure, you perform an incision and remove the cyst with the cystic epithelial lining Caiaimage/Martin Barraud / Getty Images. If you or a loved one has had surgery recently, you may be concerned about the surgical incision site—how to care for it, what it looks like, and if it appears to be healing properly. One thing to be aware of is drainage from the site, known as exudate.While it can be alarming to see drainage from a surgical wound, usually it's perfectly normal and. There are numerous incision and drainage procedure codes that are specific to the incisions and drainage of an abscess in various anatomical sites. Therefore, it would be appropriate to bill these more specific incision and drainage codes. For example: an abscess of the eyelid should be billed with procedure code 67700 (Blepharotomy, drainage. CPT classifies some incisions as complicated. The following codes for complicated incisions will be recognized when they meet the following guidelines: 10061. Incision and drainage of abscess (e.g. carbuncle, suppurative hidradenitis, cutaneous or subcutaneous, abscess, cyst, furuncle, or paronychia); complicated or multiple

Incision and Drainage - What You Need to Kno

Incision and Drainage - researchgate

Incision and Drainage Procedure to Treat Abscesse

Incision and drainage is a procedure to open and drain a pilonidal cyst. You may need this procedure if the cyst becomes painful, swollen, or infected ( pilonidal abscess ). There are three types of procedures to drain a pilonidal cyst. The type of procedure you have will depend on the size, location, and severity of your cyst incision - the cutting of or into body tissues or organs (especially by a surgeon as part of an operation) surgical incision , section cutting , cut - the act of penetrating or opening open with a sharp edge; his cut in the lining revealed the hidden jewel

Incision and Drainage Operative Report Transcription Sample

Incision and Drainage (Ambulatory Care) - What You Need to

PARONYCHIA, INCISION, AND DRAINAGE | Surgical Methods. 1-04. PARONYCHIA, INCISION, AND DRAINAGE. a. Definition and General Considerations. Paronychia (figure 1-2) is defined as the inflammation of the tissues around the nail. Another name for this condition is whitlow. General conditions that are pertinent to this condition are listed below For incision and drainage of a complex wound infection, use CPT 10180. You can remove the sutures/ staples from the wound or make an additional incision to work through. The wound is drained and any necrotic tissue is excised. The wound can be packed open for continuous drainage or closed with a latex drain

Incision and Drainage Anesthesia Ke

Incision and drainage for abscess management (Source: NEJM) Posted By Rob Stenstrom on November 17, 2017. ADDITIONAL RESOURCES Cutaneous Abscess Management - Clinical Summary (Rob Stenstrom) COMMENT AND OR SUGGEST A VIDEO. SHARE. COMMENTS (0) Suggest a Resource. 08:38. 0 2405. Incision and drainage if adequate equipment is available. 2. Make the incision over the medial aspect of the mucosa, at the point of maximal fluctuance. 3. Insert a hemostat through the mucosal incision and spread the tips into the deeper tissue. Ensure there is entrance into a true cavity. 4. Irrigate with a syringe and catheter technique. 5

incision and drainage - German translation - Lingue

In the drainage of an abscess, the incision should be made at the point of maximal fluctuance. If possible, it should be made in a dependent area; however, a dependent incision should not be made if a tubercular etiology is suspected. Ideally, the direction of the incision should be in line with the natural skin crease Surgical procedures involved incision and drainage of abscess (either intraorlly or extraorally) and removal of source of infection. (1) This procedure is considered useful because it is less invasive than a surgical incision and drainage and is tolerable for patients in poor condition

Synonyms for Incision and drainage in Free Thesaurus. Antonyms for Incision and drainage. 18 synonyms for incision: cut, opening, slash, notch, slit, gash, cut, gash. Our LATEST youtube film is ready to run. Just need a glimpse, leave your valuable advice let us know , and subscribe us! Deeply thanks! We are pleased to provide you with the picture named Incision And Drainage Of A Skin Abscess Diagram.We hope this picture Incision And Drainage Of A Skin Abscess Diagram can help you study and research. for more anatomy content please follow us and visit our.

Prepackaged incision and drainage trays help standardize product usage and control supply costs. Include high-quality, single-use, stainless-steel, Centurion instruments that are precision crafted to match the performance and feel of reusables. Many Centurion instruments qualify for our money-saving Recycling Program; contact your sales rep for. Description. Busse's Incision and Drainage trays provide the key components and instruments needed for clinical lancing in these minor procedures conducted to release pus and pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus Incision and drainage synonyms, Incision and drainage pronunciation, Incision and drainage translation, English dictionary definition of Incision and drainage. a surgical cut into soft tissue; a notch as in the edge of a leaf Not to be confused with: abscission - an act of cutting off; the process by which plant..

Incision and drainage of a joint is surgery to remove fluid and other material from an infected joint. When is it used? Removing the fluid and other material from the infected joint may reduce pain and swelling and prevent damage to the bones and other tissues. It also helps prevent spread of the infection Post-Operative Pilonidal Wounds and Drainage. There is much conversation between patients and surgeons, and among patients themselves, regarding the appearance of their post-operative incisions, wounds, and drainage after pilonidal surgery of all kinds. I am going to attempt to discuss some of the things that patients observe, and what they. N2 - Concomitant anal fistulotomy (F) and incision and drainage (I and D) of ischiorectal abscesses (IA) are often avoided, for fear of irreversibly impairing anal continence. However, failure to identify and treat the frequently associated trans-sphincteric anal fistula dooms the patient to recurrent anal suppurative disease Concept ID: 363157001. Read Codes: ICD-10 Codes: Not in scope. Incision and drainage of bursa of foot. Incision and drainage of cranial sinus (procedure) Incision and drainage of cul-de-sac (procedure) Incision and drainage of deep abscess of soft tissues of neck. Incision and drainage of deep abscess of soft tissues of thorax Incision Care and Drainage FAQs . Incision Care . Q. Can I wash, shower, and or swim after surgery? • Showering/Wash o Standard glue- patient can shower right away and pat dry o Staples/Nylon Sutures- patient can shower • Swimming o Wait until post-operative visit. o No swimming until minimum of six weeks. Incision must be completely heale

Abscess Incision and Drainage (I+D)

Many other people have had similar concerns, too. In fact, information about Incision and Drainage services have been asked over 311 times in our community here at Erufu Care.. So being part of this online healthcare community here, we always work to find and compile information on Incision and Drainage services in Penang based on surveys, recommendations, and treatment experience feedback. Incision and drainage was deferred, and a plastic surgeon was consulted. The consultant was unable to see the patient in the ED and followed him up in the office. The patient underwent exploration of mass in the operating room. Despite a surprising amount of blood loss, the mass was successfully removed, and a vascular connection was tied off What role do antibiotics have in the treatment of uncomplicated skin abscesses after incision and drainage? A recent study suggested that, for small uncomplicated skin abscesses, antibiotics after incision and drainage improve the chance of short term cure compared with placebo. Triggered by this trial, the Rapid Recommendation team produced a new systematic review Intercostal Drainage Tube • The concept of chest drainage was first advocated by Hippocrates when he described the treatment of empyema by means of incision, cautery, and insertion of metal tubes. • However, the technique was not widely used until the influenza epidemic of 1917 to drain post- pneumonic empyema, which was first documented by.

Incision and drainage Incision and drainage and clinical lancing are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus. It is performed by treating the area with an antiseptic, such as iodine-based solution, and then making a small incision to puncture the. Check prices and reviews of 9 quality Incision and Drainage clinics in Malaysia, rated 4.7 over 5 from 179 verified reviews by our community medical support network. View doctor profiles, clinic contact information and photos. All clinics verified by ministry of health Malaysia. Send an enquiry and get response fast - Updated Jun 202 Incision and drainage of an abscess is a safe procedure, however, there are uncommon risks that may be associated with it. While we have discussed these and possibly others in your consultation, we would like you to have a list so that you may ask questions if you are still concerned. It is important tha One hundred and thirty-seven consecutive acute superficial abscesses were randomly allocated to incision, curettage and primary suture without parenteral antibiotics (64 cases) or to conventional treatment with incision, drainage and dressings (73 cases). Wound healing was faster; 7.0 days: 25.1 day Some incisions may also have a drain — a rubber tube that extends out of the incision at the skin's surface. This is often used in wounds and in situations when there is significant drainage or a high risk of infection. This will prevent drainage fluids or pus from accumulating in a pocket beneath the skin (called an abscess), which.

Incision and drainage — ACDIS Forum

The midline incision is the preferred incision due to adequate exposure of intra-abdominal contents, quick access, and relative ease to perform.1-3 Laparotomies are associated with a number of complications like wound dehiscence, wound infection and incisional hernias.1,4,5 Midline laparotomy incision is generally chosen by surgeons because of. Best incision and drainage of abscess doctor in Hyderabad. View appointment fee, patient reviews and feedback, OPD schedule, contact number of incision and drainage of abscess specialist near you in Hyderabad. Book appointment online with incision and drainage of abscess doctor at top hospitals - Credihealt Incision and Drainage of a Felon Hazel Guinto-Ocampo Introduction A felon is an abscess of the distal pulp or pad of the fingertip (1,2,3,4,5,6,7). The most commonly affected digits are the thumb and index finger (8). Unlike a paronychia, a felon is a deep soft-tissue infection that involves the distal pulp of a finger o Recovery from Incision and Drainage of Abscess. There is usually little to no downtime following this procedure incision and drainage of an abscess, depending on the size of the abscess. You will be given instructions on how to remove the packing from the cavity. You will also be told how to best wash the area to prevent infection

Incision and drainage - wikido

Drainage Catheter Kit (5) Drainage Catheter Tray (4) 3-Spring Reservoir Kit (3) Incision and Drainage Procedure Kit (3) Drainage Catheter (2) Incision and Drainage Procedure Tray (16) Chest Tube Set (5) Pleural Drainage Kit (5) Wound Drainage Kit (5) Peritoneal Drainage Kit (4) Procedure Tray (4) Reservoir Kit (3) Gastric Lavage Tray (2 An incision is the deliberate cut that is performed into the body's tissues, while an excision involves taking tissue out, such as with a biopsy or an inflamed appendix. As surgeons work with a large number of both incisions and excisions, their uses are governed by what specifically needs to be accomplished surgically and the health condition. Immediate drainage is imperative to relieve increased tension and prevent development of osteomyelitis of the distal phalanx. For a deeply situated abscess, the incision can be made longitudinally along the ulnar side of the digit 3-mm volar to the nail edge Consent should be obtained from the patient or family member, when appropriate.{ref6} The reason the procedure is being performed (suspected diagnosis); the risks, benefits, and alternatives of. Incision for scrub nurses& nurse anesthetists. We offer access to continued surgical improvement in a scaleable way. 100+ courses on devices & instruments, skills & principles. Just-in-time learning for efficient OR prep. Anytime, anywhere, on any device. See all features

  • شعر عن قرب العيد.
  • الرخام افضل أم الجرانيت.
  • زوج توبا الثاني.
  • دراسة الطب بعد البكالوريوس.
  • شجرة الفلفل الكاذب.
  • الكتابة على الرمل للاطفال.
  • IPad 3 سعر.
  • افضل برنامج توضيح الصور المشوشة للكمبيوتر.
  • صديقتي احبك في الله.
  • مضار الفاصوليا البيضاء.
  • اسم دورغا الحقيقي.
  • فقاعات صابون بالانجليزي.
  • مخاط مع البراز وغازات عند الرضع.
  • تقطيع البصل بدون دموع في المنام.
  • زينة كنيسة للاعراس.
  • رسائل تهنئة بيوم عاشوراء.
  • عدد سكان الصريح 2020.
  • ستيك هاوس مخرج ٥.
  • شعر الصباح نزار قباني.
  • تجديد الجواز الإماراتي في مطار دبي.
  • تجاذب المغناطيس فطحل.
  • القنابل العنقودية.
  • متلازمة أنجلمان أطفال الخليج.
  • الامبراطورية بث مباشر.
  • موقع اوميغا.
  • قرعة أولمبياد طوكيو 2020.
  • البيض النيئ مع الحليب لزيادة الوزن.
  • معنى كلمة المهادنة.
  • دهانات غرف نوم اطفال.
  • مفهوم الدعم النفسي الاجتماعي و انواعه وكيفية تطبيقه pdf.
  • دورات التجارة الالكترونية بالسعودية.
  • خلفيات عمرو دياب للكمبيوتر.
  • وزارة الدفاع العراقية مديرية ادارة التطوع 2020.
  • حجم الصورة 4 في 6.
  • Sully (film).
  • حلاوة روح اغنية.
  • حجب الرؤية عن حارس المرمى.
  • تمارين مقترحة في الاحتمالات باك 2020.
  • أفلام الحرب العالمية الثانية 2020.
  • خواتم الماس ٢٠٢٠.
  • عملية الناسور العصعصي جراحة.