Job Shadow #2

My second job shadow was spent on burns. During burn rotation with Dr. Ryan Deci and Dr. Butts, we worked on two complex burn cases and spoke about a third. Our first patient was a female with severe bilateral burns on both feet. As a diabetic with neuropathy, she had lost sensation in her feet and unknowingly burned them while standing in a hot shower. The extent of her injuries was significant, her right foot had a 6x10 cm burn, while her left foot sustained a 12x10 cm burn. To facilitate healing, a skin graft was taken from her left thigh. The process involved using saline and epinephrine to lift the skin, making it easier to harvest the graft while minimizing bleeding. The excised graft was then carefully placed over the burns on her feet. Medical students Ryan and Kylee assisted, observing the technique required to ensure the graft adhered properly and had the best chance of survival. 

The second surgery involved a male patient who had suffered extensive burns from a house fire. His injuries included burns to his right flank, right arm, abdomen, and chest. This procedure focused on replacing a previous donor graft with a new one, ensuring better integration and healing. Graft replacements like these are necessary when the original graft fails to take or becomes compromised due to infection or poor circulation, in this specific case it was poor circulation. The team worked to remove the old graft and secure the new one, ensuring proper adherence and coverage. The third case was another male patient, this time with severe burns on the posterior side of his legs and buttocks. Given the extent of his injuries, an allograft was chosen as the best treatment option. Allografts, sourced from cadaver skin, serve as temporary biological dressings to protect the wound and promote healing until the patient’s skin can be used for grafting. While temporary, this procedure is crucial in preventing infections and reducing pain as the patient continues to recover.

With this experience, I have learned that burn surgery is not for me. A big part of burn rotation is the OR, which is set at a rather high temperature to provide heat the body lacks because of the compromised areas. I do not do well in the heat. Although the experience is greatly valued, I found burn surgery to be rather boring. It seemed like it was always the same operation repeated over and over. I feel better suited in an environment where there is no definite event, it's always something different. You live and learn, I guess.