First ten rows may get wet

So week two flew by in a whirlwind of surgery, clinic, and 12 hour days. I find it amazing how many hours the plastic surgery residents and doctors put in, yet are able to still produce beautiful cosmetic results. Last Friday, after a potpourri of surgeries, one of the residents realized that over a 36 hour period she had only not been in the operating room for 5 of those hours. Here I was at 7 pm about ready to curl up on the OR floor and take a nap, while she was just suturing away looking perfectly fine. It was actually that last surgery of the day that was one of the more “routine” cases I have seen, a skin graft. I say “routine” because I have seen three of them so far in the 20+ surgeries I have had the chance to look in on. Apparently plastic surgery affords you the luxury of seeing a little more variety in the cases you handle on a week by week basis.

The skin graft procedure also is one of the easier and quicker types of procedures I can describe. Basically what happens is a donor site, usually the upper thigh, has a small slice, about 14/1000ths of an inch, removed via a dermatome. This piece of skin is a layer of epidermis and a partial layer of dermis which still has the ability, if properly cared for, to reintegrate into the affected area. Prior to final attachment, the recipient site is debrided to ensure maximal coverage and post attachment, a vacuum seal created to protect the graft. I stress properly cared for because during clinic hours I have seen a surprising number of follow up patients who have not cared for their grafts properly. This negligence and lackadaisical attitude in not taking an active role in your own healthcare more often than not causes the graft to fail. This ultimately winds up costing the patient, hospital and doctors time, another trip to the OR, and money spent unnecessarily. I suppose it is this lesson of personal involvement that is the greatest one that I am learning throughout the course of my summer. What I have also noticed is that quite a few doctors, once they find out I’m an engineer, seem to request devices that can prevent complications by performing functions that patient’s should themselves have an active role in if they follow all of the doctors orders.

Regardless, I have also seen some dramatic and messy operations. As the title of this post says, things are not always cut and dry. Actually, it never is, so if you ever find yourself in the OR make sure to be on your toes and far enough back to avoid doctors, nurses, and projectile objects. If you are interested in the other cases I have seen that are way more graphic in nature than skin grafts feel free to contact me. Surgeons can do some crazy things with muscles.