Julia Bellamy / Dr. Jason Spector - Week 3

This week I shadowed a burned hand scar contracture excision with placement of a full thickness skin graft (FTSG) by Dr. Adam Jacoby in plastics at DHK. This patient had healed from this injury on the hand years ago and is now having this surgery to regain full mobility of the hand. Four of the five fingers had a Z-plasty performed. This allowed the release of the scar on the fingers in the vertical direction and redirected the new scar lines perpendicular to the movement. This would allow for reduced tension on the wound. One of the fingers, the scar was much thicker than the others, an a FTSG taken from the medial groin region where the skin had a lot of laxity was transplanted over the missing skin on the finger. India and I also met with Dr. Roger Hartl's team in neurosurgery to discuss the tissue collection logistics for samples sent back to the Ithaca campus and other members in our lab. We then collected this tissue sample from a TLIF (Transforaminal lumbar interbody fusion) case where bone marrow aspirate concentrate (BMAC) was collected and re-infused into the patient. The BMAC that was not used was collected and delivered to Dr. Raffi's lab for processing.

I also shadowed Dr. Spector in clinic this week. One patient was a video visit about the plan for a surgery in collaboration with Dr. Fragman at HSS. Dr. Spector discussed the use and process of implanting tissue expanders for the bone surgeon to have extra skin to close at a later date. We learned that the first tissue expanders were condoms in the 1950s. We then went on a "field trip" from the clinic to Och Spine and HSS to follow up on spine closure cases and give patients care instructions before they are sent home. Another patient was on a follow up from the first OR case we saw on immersion - the tongue reconstruction from a radial artery flap and microsurgery. It was interesting to see how fast the flap on the tongue was healing and the removal of the arterial implanted dopplar device. We also saw a patient get Juvaderm Voluma filler injections in the face, and then get a vasovagal reaction and briefly pass out.

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