This week I increased my time in the lab, working on my tissue constructs, and learning from the med student who began this project last summer when he worked in the lab. The two of us get to work together for the rest of the summer which is nice. He’s taught me how this project has evolved and helped me appreciate the simplicity of our new polymer.
I attended Spector’s surgeries as usual and was able to see a few office hour patients. Tuesday’s surgery was on a middle aged Italian woman who presented with a hematoma in her right cheek. Her Italian doctors decided to radiate her, as that was their philosophy at the time, and she developed cancer in her cheek. ENT excised a large portion of her cheek and the patient was left with a huge hole. Sector worked with this, widening the hole a little and making sure the main vessels that supply the cheek were preserved. While he was working up top, his Fellows were working on harvesting a flap from her arm. It was the Fellows’ first free flap and they cut the main blood supply to the hand, so rather than excising a flap, they had to quickly repair her arm and then reposition the patient, sterilize, and prepare to take a flap from the other arm. Dr. Spector was very nice about the whole matter. “What are you going to do?,” he asked, “You’re going to f- up, the thing that gets me is laziness.” That’s what he doesn’t tolerate. It was intensive in the OR for a little, and the case became bigger than it was originally intended to be, but in the end it was a successful surgery. When the Fellows’ cut the ulnar artery, Spector just had the resident who was on his service last rotation scrub in, as she was visiting anyway, and oversee their procedure. As this was happening, I thought of how people always tell you not to get sick in July, as July 1st is the national day for residents to begin new services. It was good to see how mistakes were handled.
The other surgery that I really enjoyed was the removal of a tissue expander from the neck of a 7 year old boy. I’ve seen this boy come in every other week since I’ve been here, and we’ve injected saline into his tissue expander and sent him on his way. On Wednesday his tissue expander was finally removed and the skin taken from his neck was used to reconstruct his chin and cheek, all the way up to his eyeball. The patient is a burn victim who was caught in a house fire. His entire face was scared. He will have to undergo other procedures, including a nose reconstruction later, but this was definitely a step in the right direction. Dr. Spector had to cut away a lot of scar tissue before he could replace the tissue on the boy’s face. We rounded on him the next day and he was doing great- sitting up watching Sponge Bob – he was just ready to go home.
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