Week 6 - A Series of Infections

This week, I was able to spend a bit of time with the Spector lab and in the OR. First, I attended clinical rounds, where I was again given the opportunity to interact with pre- and post operative clients. Later that day, I was invited to a journal club over dinner as well as an M&M Conference (Mortality and Morbidity). At the conference, myself and a few other cohort members saw a few difficult cases that could've been handled differently to minimize complications. In analyzing these cases, some of the pathology work I’d observed in Dr. Westblade's lab was pertinent, especially with regard to complications involving systematic or local infections. It was also interesting to see clinicians make tough decisions and determine when bacterial cultures are necessary vs unnecessary (and how a lack of culture data can influence medical decisions). 


Next, I was able to see an operations with Dr. Glesby, Dr. Milstrom, and Dr. Spector. 

The first surgery I was able to observe was another tumor removal and mandible restoration with Dr. Spector. For this patient, we were previously able to see the implant, cutting guide and mandible reconstruction design- now it was time for the actual surgery. I was able to see the whole process from start to finish, from pre-operative prep to the surgery, and finally the post-operative procedure during clinical rounds. 

The next surgery was with Dr. Glesby. The patient suffered from a complicated gut infection, resulting in tissue necrosis and almost complete removal of their abdominal wall. To address this issue, a graft from their latissimus was used in place of the necrotic tissue, and tissue inflaters were inserted to promote skin growth. The new skin would then be attached to cover the graft. The graft itself prevents the patient’s intestines from shuffling underneath the skin, and their abdominal components were sealed with a mesh prior to installation of the graft.

After observing that surgery, I was able to head to another OR with Dr. Milstrom. His case featured another complicated bowl infection. Dead tissue was removed, and the remaining sections of the intestine were again secured with a mesh. A small portion of the patient’s intestine was connected to a small drainage bag, and sponge was placed at the site of the large, open wound. In this case, I was able to see injury maintenance- the sponge was removed, additional dead tissue was cut away from the large opening and it was then irrigated and suctioned. A new sponge was then placed at the site and the patient was re-realeased into the ICU.


On Friday I attended plate rounds with the Infectious Disease fellows. 

There have been a few additional troubles on the research side with shipping materials, but I hope to finally get to running gels next week at the very latest. 

 - Taylor

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