Week 2

My second week of being immersed involved meeting with patients during Dr. Spector’s clinic days and observing more surgeries. One interesting case involved a patient with a large tumor on their neck. The tumor had to be excised and the resulting void in tissue must be replaced. After the head and neck surgeon carefully removed the tumor and nearby lymph nodes, Dr. Spector’s team worked on repairing the resulting defect. This was accomplished by using a technique known as a rotated flap. During the procedure, Dr. Spector mobilized the patient’s pectoral muscle and moved it to the neck where the tumor was previously located. However, the muscle wasn’t fully detached to keep a blood supply to the rotated flap. This would allow the muscle to integrate into the new wound and facilitate repair by introducing a healthy blood supply. This procedure contrasts with a free flap, where tissue can be completely removed from distant parts of the body and placed on the wound. In this case, the surgeon needs to manually reconnect the blood vessels to ensure that the graft can integrate into the wound and survive.

Upon seeing the patient the next day, the repair seemed to have been successful and the patient didn’t seem to exhibit decreased facial movements. Additionally, the area where the repair was done looked relatively normal. Although the procedure was successful, I feel as if creating a new wound to repair an existing one seems somewhat counterproductive. A manufactured synthetic or biological tissue graft could be used for such a repair. However, the graft would need the ability to rapidly integrate with the existing tissues and surrounding blood vessels. Additional research is required in order to create an artificial graft with comparable results to the patient’s own tissue.

Next week, Dr. Spector will be out of town. During this time, I hope to dive into the research projects occurring at lab.

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