Standard betadine prep.  Tourniquet placed over L tarsometatarsus.
Obtained fluoro images. Incised over previous incision at L D4
amputation site.  Found pocket of purulent fluid containing some
encapsulated material believed to be the suspected sequestrum.
 Sampled the site for c/s.  Removed the purulent material and
fluid, lavaged copiously.  Obtained additional fluoro images.
 Confirmed removal of bone back to the proximal phalangeal joint.
 Did not debride the bone surface. Lavaged again.  Closed the
soft tissues with 5-0 PDS.  Apposed the skin with 5-0 PDS SI.
 Removed tourniquet, no significant hemorrhage. Placed ID bandage.

Patient was sedated using described drugs for CT, placed in ventral recumbency in blue box, and CT scan was performed. After scan, patient was reversed using drugs described above, and recovery was uneventful. CT report to follow.

After induction and intubation, went to radiology for imaging,
then proceeded to OR.  Dorsal recumbency, plucked feathers around
R pectoral wound, taped feathers out of the way, standard aseptic
prep.  Draped sx site, bluntly and sharply debrided non-viable
tissue from the wound.  Trimmed skin circumferentially to freshen
edges.  Tacked SQ tissue in center of wound with single 4-0 PDS
suture.  Closed the skin in two halves with 4-0 PDS SC.  Covered
with surefit bandage.
Left foot was hung and aseptically prepared with betadine. A
tourniquet was placed around the L tibiotarsus.  Incisions were
made laterally and medially along the digit to facilitate dissection
of soft tissues.  The digit was disarticulated between P3-P4.
 The extensor and flexor tendons were secured with stay sutures.
 The distal end of P4 was rongeured to remove the articular cartilage.
 The extensor and flexor tendons were sutured to each other over
the end of the bone to provide padding.  Non-viable tissue was
debrided.  The skin was apposed with 4-0 PDS SI. The tourniquet
was removed - return of blood flow was visible. TAO was applied
to the site and it was covered with a telfa and interdigital
bandage.