Jenny Deng Week 1: Acclimating to a medical teaching hospital

Me, Faith, Julia, and India met Dr. Jason Spector on the first day. He was welcoming and enthusiastic to have us shadow him and work in his lab. We met Sophia and Dr. Xue Dong from his research side and Dr. Jaime Bernstein and Dr. Ann Ni on the surgical side. The next day, we were invited to see a case Dr. Spector was in. This would be my first time in the operating room. For this particular case, a radial forearm flap was being utilized to reconstruct part of a tongue that was partially resected due to oral carcinoma. The ENT team were operating near the head and the plastic surgery team by the arm. It was less bloody than anticipated. A large Zeiss microscope was rolled into the OR for the microsurgery portion that required joining the donor and recipient site blood supply. The following day, we saw multiple other surgeries: a melanoma on the scalp required exposing the area in preparation for a second surgery with a graft. Everyone was excited about doing the surgery, and Dr. Spector was quizzing a medical student, Austin, about treatment options. Austin was also very helpful in explaining to us the reason why a temporary scaffold was placed on the scalp: Integra, a wound matrix composed of shark and bovine type 1 collagen, was dressed over the area, promoting cellular invasion into the area (see image below). This is particularly important to establish a vascularized foundation for a graft. Another surgery involved removing keloids, benign scarring that results from excessive collagen production during healing. Interestingly, though benign, keloids may return even after resection, and radiation or topical steroids are often used in conjunction to treat the area. Finally, we saw a facial lift procedure to amend partial face paralysis and droopiness that resulted from resection of the parotid gland due to cancer. It was fascinating watching the initial incision in the face. A mesh was sutured into the area to provide a lifting effect. Everyone in the OR has been so incredibly kind to have us in the room! Being in NYC's hospital hub is also fascinating: MSKCC, NY Presbyterian, Columbia, and Rockefeller are all in the area. Everyone seems incredibly intelligent.    

Integra wound dressing: Shark and bovine collagen type 1 matrix.