Week 3: A little more lab time

This week was a slight change of pace, as Dr. Spector was out of town on Monday and Friday. Terence and I started Monday in plastic surgery conference, during which Dr. Hoffman presented face lift techniques and one of the residents discussed hand fracture management. The rest of the day was spent in lab, where I learned how to do paraffin embedding (now I really appreciate the work the histology core does) and also thawed some breast cancer cells.

Tuesday was also largely a lab day. I brainstormed some project ideas with Terence’s help, and we tried to troubleshoot some of the protocols that Spector Lab has had difficulties with, notably the set-up of a perfusion pump that is used for dynamic flow experiments. On a visit to Dr. Spector’s office (we thought to discuss experimental plans), we went on impromptu rounds and followed up with patients for about two hours. Dr. Spector discussed with one patient that they may have a condition called pyoderma gangrenosum, which causes ulcers on the skin after any sort of trauma or injury to the skin. He had been perplexed by when the patient had come in a week earlier, because at one week post-op the skin graft appeared to have been healing well. This had also occurred once before, on another skin graft that Dr. Spector did for them. Dr. Spector recommended no further treatment, and to just let the graft heal on its own, as the etiology is unclear.

In the OR on Wednesday, we saw an upper lip reconstruction, split thickness skin graft for a 30 cm x 30 cm wound (had previously seen debridement), and irrigation and debridement of a pseudoaneurysm near the groin. The psuedoaneurysm formed after the patient had percutaneous aortic valve replacement surgery, but femoral artery (where the catheter was inserted) was not fully closed. Blood leaked into the surrounding soft tissue (hematoma) until the pressure matched that inside the artery. Dr. Spector’s team made sure the artery was closed, and washed out the surrounding area of leaked blood.

Thursday morning we were in clinic, followed by more time in lab. Terence and I made a PDMS mold for some vascularized collagen constructs that I will be making for my experiments, and we went to lab meeting. Before the end of the day, Dr. Spector set us up to see endovascular surgery with Dr. Sharif Ellozy the following day, since he would be out of town.

We started with Dr. Ellozy at 7:30am on Friday morning, donning lead protective gear to watch as he cleared some vascular occlusions in a patient’s leg through the iliac artery of the contralateral leg via x-ray guidance. I was amazed to see how minimally invasive yet precise this technique was—through careful manipulation of specifically engineered wires inserted through a single catheter (single incision), Dr. Ellozy was able to skillfully perform angioplasty with paclitaxel-coated balloons-eluting polymer-coated tubes, effectively clearing blockage and preventing restenosis with one treatment!