Week 4 Plastics- Lindsey

With the 4^th of July Holiday on a Monday, this was week was a little slower than usual. We only had one day of office hours- Thursday. I was able to see some patients healing very nicely from their surgeries. One thing I noted, was how the skin paddle that was taken from another section of the body, along with its surrounding tissue and veins, and later attached to the inside of the mouth shrunk a great deal with time. It really became one with its environment and barely detectable on the inside of the mouth. The most interesting office patient award went to a lady who came in for the removal and a barely noticeable mole between her eyebrows and an extremely microscopic mole between her breasts.  She wanted to know if they could be removed today because they bothered her. Sure enough,  she was moved to the office in-patient surgery room and treated as the last patient of the day.  Dr. Spector was able to remove the mole between her breasts with one scrap of his scalpel.  It’s funny the range of patients that come into see him.

His most interesting OR patient was a 13 year old girl who got into a bad jet ski accident. I observed her 3^rd surgery. Because of compartmentalization they had to make large incisions on both sides of her lower leg.  Screws were placed in to hold her bone together. All this was done in the country in which she had her accident. She then came back to the US and plastics closed one side of her leg and left the other open in the hopes that the swelling would go down and a smaller skin graft could be taken. This third surgery that I observed was for the closing of the outer side of her leg.  Orthopedics came in first and placed some more screws in and then plastics grafted and closed it up. As the girl’s teeth were injured in the accident, general anesthesia wasn’t given, for fear it would further damage her teeth.  The result was that, despite her epidural  and other medications, the girl would scream out during parts of the surgery. “please stoppp!”, “help me nurses, help me!”  Needless to say it was not as amusing at the time, the anesthesiologist was on edge, and everyone wanted to get done as soon as possible.

I was also able to see a 9 month old undergo surgery this week. The sutures on his brain were fused on one side and the result was an abnormally shaped elongated head that could later induce seizures and brain swelling. The surgeon cut a zigzag pattern through the back of the child’s scalp and pulled the skin away from the skull.  A wire mold/outline of a normal forehead was then matched to a spot on the skull and the place was marked. Sections of the skull were then removed and pieced back together like a puzzle. It was a great surgery to watch, filled with lots of teaching for the new students.