CPT® Code 25145

A sequestrectomy is a surgical procedure specifically designed to address conditions such as osteomyelitis or a bone abscess affecting the forearm and/or wrist. The term "sequestrectomy" refers to the removal of a sequestrum, which is a segment of necrotic, or dead, bone that has detached from the surrounding healthy bone tissue. This detachment often occurs due to infection or other pathological processes that compromise the integrity of the bone. During the procedure, a surgical incision is made through the skin and soft tissue to access the affected area. If the periosteum, which is the dense layer of vascular connective tissue enveloping the bones, is found to be healthy and viable, it is carefully lifted away from the necrotic sequestrum. The surgeon then excises the dead bone, and the elevated periosteum is repositioned to cover the resulting defect in the cortical bone. In cases where the periosteum is not viable and an involucrum—a layer of new bone that forms around the sequestrum—has developed, the necrotic bone is removed while preserving the involucrum. This approach allows for the potential regeneration of new bone within the defect. Finally, the incisions in the soft tissue and skin are sutured closed, and a dressing is applied to protect the surgical site during the healing process.