Friday, February 12, 2016

Week 1/ First Cut

Hello!

Today marks the end of my first week spent at my project site, Banner Health!


Tuesday was the first day I started work at Banner. As Dr. Truong had clinic, I got started on something that will be integral to the research component of my project—suture tying. Dr. Truong taught me to tie a ‘square knot’, and both the one-handed and two-handed methods. Although it may seem quite easy to do, each ‘square knot’ requires two separate ties to complete.  Which suture lies on top as well as which hand pulls in which direction matters greatly as well. If anyone is interested in learning how to tie a one-handed/two-handed square knot, click here.


(Day 1) Here I am, testing my skills on a suture tying kit! The knots tied on the left are mine, the knots on the right (which, as you can see, are 100000x better) are Dr. Truong’s (he kindly helped me even with his busy schedule during clinic).

On Wednesday, I finally obtained my observer’s badge (pictured below), and got to watch my first surgery in an operating room! The first one I watched was an inguinal hernia repair—something that I had actually heard of from taking Anatomy (thanks Mr. Nishan)—but during the procedure I was quite lost. Dr. Truong made a very small incision (less than 2 inches) in the groin area. For the next hour or so, the main task was to find and seal off the hernial sac, in which fluid had accumulated. When the procedure was done, another surgeon closed off with subcuticular sutures, using vicryl (a type of absorbable suture). Preventing scarring was very important, Dr. Truong said, as the incision area is all the parents would be able to see at the end of the procedure. At the very end, a syringe filled with lidocaine (a local anesthetic) and epinephrine (to reduce bleeding) was injected near the incision. A type of surgical glue (called Dermabond) was applied to the area; I was told this glue is chemically similar to the super glue we normally use—how strange is that??

Being in an OR was very different from what I had expected. Music played in the background, and though the surgeons were intent and focused on their work, the general atmosphere was quite relaxed.

My badge to enter the OR


(Day 2) On my second day at Banner, I was given the amazing opportunity of watching one of Dr. Truong's procedures right in the operating room. Here, I'm wearing the scrubs assigned to me to wear into the OR.

It’s only been a week since the start of my senior project, but I feel as if I have already learned so much. Can’t wait for the weeks to come!

All the best,

Vanessa

13 comments:

  1. Vanessa....you look so professional! What a great opportunity for you. Enjoy your experience. I'm glad that you had recollection of what we talked about last year. I'm sorry I won't be able to hear your presentation. I'm sure it will be awesome. Good luck.

    ReplyDelete
  2. Nice knots and great scrubs! The surgical procedures sound fascinating, and I'm greatly interested in the neatness and precision of the incisions, especially in pediatric patients. By the way, what age range will you be working with?

    Also, thanks so much for the link to the square knot tutorial (very cool, reminds me of needlepoint knots).

    I'm glad you're having a great experience!

    ReplyDelete
    Replies
    1. Thanks Mia!! To answer your question, I believe that Dr. Truong and Dr. Vegunta work with infants, children, and adolescents (so 0-18 years of age). Also, I'm glad you could connect what I learned about tying surgical knots to needlepoint. That's a really cool connection that I probably never would've made..thanks for pointing it out! (:

      Delete
  3. Vanessa, you look great in scrubs!!! You knot tying skills are already outstanding.

    When I was young, a dog bit my finger and the ER physician used Dermabond to seal my finger - he also likened it to super glue! However, I don't remember having a suture. Are sutures and Dermabond a common combination or is one often used without the other?

    I am eager to hear your observations over the course of your project. I was very surprised to hear how relaxed the OR can be!

    ReplyDelete
    Replies
    1. Ms. Mitrovich, thank you so much!! Regarding the use of Dermabond in conjunction with sutures, I spoke with Dr. Truong today and he says that he typically uses surgical glue as a type of 'dressing', after closing with sutures. He also mentioned that sometimes, in emergent cases (like your bitten finger), Dermabond is sometimes used alone to stem the bleeding.

      Delete
  4. Hey Vanessa, your last update is really cool! You say the operation took about an hour, is this a long time for an operation or is this about average? I'm guessing it depends on what is being operated on I guess, but most stuff can't take that long right?

    ReplyDelete
    Replies
    1. Thanks Luke! Based off the operations I have observed so far, I would say an hour is pretty average (however, this may just be due to the types of procedures). Today I watched two operations, one that lasted more than 2 hours (to take out a renal mass), and one that lasted only for about 20 minutes (this was to insert a drain for an abscess). Like you said, I think it depends on the severity of the case and how complicated the procedure is. Hope this gives you a better idea! I'll keep you updated as I spend more time watching in the OR as well.

      Delete
  5. Hi Vanessa, I never thought that an operating room atmosphere would be that calm; maybe I've been watching too much House. I don't think I could ever be able to comfortably watch a surgical procedure, how do you feel towards it?

    ReplyDelete
    Replies
    1. Hi Alex! I never thought that it would be that calm either (but maybe that's because I've similarily been watching too much Grey's Anatomy..), but throughout the procedures the surgeons and nurses seemed unfazed and the music in the background seemed to take the edge off a bit. Maybe it was because I was watching a routine procedure (that was also non-life threatening--I imagine if I were observing an emergency surgery it would have been a lot more fast-paced/agitated). Personally I was a bit intimidated by the bright lights and surgical equipment, but other than that it was okay. I'll be heading back into the OR tomorrow and will let you know if anything changes!

      Delete
  6. Vanessa! I loved reading your post! I was also super surprised the first time I went into an operating room to see how calm it was! I loved your first post!

    ReplyDelete
    Replies
    1. Leah, thank you so much! Observing in an OR for the first time was definitely an eye-opening experience for me. What about you, what kind of procedure did you see the first time??

      Delete
  7. Medical coverage varies from different sorts of protection in one imperative region: as individual is in charge of giving the autos or life or some different protections however the medical coverage is given to you as a work advantage. orthopedic surgeon Charlottesville Va

    ReplyDelete