I did a little “self care” earlier this week. I did it by not caring for myself. I went to the doctor. I was sitting in the waiting area for my appointment and saw the mother of one of my patients. ”Why are you here?” she asked. “I have a doctor’s appointment.
When the very first surgeries were performed, wound closure wasn’t an issue. The surgeons often left the incisions open with the hope that they would close by themselves over time. Scarring was rarely a problem because these very first patients often didn’t survive the post-operative period, usually as a result of infection.
[Last] Tuesday's election brought us what I think must be a record number of physicians in Congress – 19. I haven't done my own retrospective analysis, but I did find a nice little piece of research from Johns Hopkins that found a total of only 25 physicians in the House or Senate in all the years from 1960 to 2004.
I wish I could say that every patient encounter worked out well, that all my patients went home happy and satisfied. It would be nice, but unfortunately that is not true at all. There are many patients who present with unrealistic expectations or an agenda which is non-therapeutic and I am relatively straightforward and unapologetic about correcting patient's misconceptions about the care that is or is not appropriate in the ED.
Since the origins of surgery many millennia ago, the goal of caring for a wound was simply healing. As the complexity of surgical procedures evolved, the same realistic outcome remained the same, that being a strong, stable closure that yields a long term, pain free, infection resistant closure.
Wiry, fair-haired and in his 60s, the patient had received a prostate cancer diagnosis a year earlier. When his doctors told him that surgery and radiation therapy were equally effective and that it was up to him to decide, he chose radiation with little hesitation. But one afternoon a month after completing his treatment, the patient was shocked to see red urine collecting in the urinal.
The following is a short interview conducted at the recent American College of Surgeons Clinical Congress with Christopher Rupp, MD, Assistant Professor for Surgery and Co-Director, Center for Pancreatic and Biliary Diseases at the University of North Carolina School of Medicine.
I think it’s clear when you look at the history of wound closure that we’ve made huge strides in terms of defining, developing and changing utilization for suture in the last couple of decades. One of the great achievements more recently has been the exploration of barbed suture.
Though I’ve spoken about breast cancer for Susan G. Komen for the Cure (emphasizing the importance of early screening and detection), until recently I had never had a mammogram. In my training I’d been taught that mammograms weren’t that accurate or useful in women under 40 (our health system’s protocols reflect that), so I got regularly checked by my physician whenever I had a physical and otherwise was waiting until I was older to get testing.
Surgeons want to be confident, efficient and safe when closing incisions to provide the best healing results. The following factors are instrumental in closing a wound: Strength - First and foremost, a wound closure device must keep the wound closed. Both the surgeon and the patient want to leave the O.
It was a beautiful time of day - early evening as the sun was setting. She has just turned sixty and traveled south to visit her 39-year old daughter in a warmer climate. Both had decided to go swimming at the local pool early one evening. The water was perfect: not too warm and not too cool. The clear blue water was made more inviting by the pool lights that illuminated the swimming lanes.
What should surgeons consider when choosing wound closure and healing solutions to attain the best surgical outcome? Recent advances in the scientific understanding of the physiology of wound healing, substantiated by clinical data on the benefits of the presence of natural healing factors, has resulted in a trend toward the use of biologic wound coverings.
Is the doctor-patient relationship really more sacrosanct than the nurse-patient relationship? That’s the provocative question asked by Theresa Brown in a recent column from Well, the New York Times’ health blog.
Oncoplastic breast conservation surgery combines breast cancer surgery with plastic surgery techniques to offer breast cancer patients an option that rids them of their cancer while providing a better cosmetic result. October 29, 2010 Dr. Melvin Silverstein is a renowned oncoplastic surgeon, Clinical Professor of Surgery at the University of Southern California Keck School of Medicine and Director of the Hoag Breast Program at Hoag Hospital.