JSL Day 1: Survived

Today's Day 1 of Junior Surgery Lab was a ton of fun.

We started off the morning at 7:30 with a brief lab introduction/orientation (including a speech about flagging somebody down if you feel sick or woozy; I was totally like "Been there, done that").

We also got a pep talk about not feeling bad for the pigs who were destined to die at noon today, at the conclusion of the lab. After all, pretty much all pigs are born to be slaughtered anyway, so isn't it nice that we can use these guys to further our educations, right?

Then we headed down to lab at 8 to meet our poor little piggies. They were all anesthetized and covered with cute little pink blankets to keep them warm in the freezing climate of the surgery lab (which is kept at nearly subzero temperatures to avoid excess numbers of vet students overheating and passing out).

Seriously, I want to know how early in the morning the surgery prep team has to get there to have 11 pigs anesthetized, IV catheters placed in ear veins, on IV fluids, intubated and on ventilators, and with some degree of monitoring equipment going on each of them. It can take us juniors on anesthesia rotation a solid 1-1.5 hours to get a dog or cat from kennel to surgery table. I'm impressed.

Today was all about skin suturing, and learning how to relieve tension when closing skin defects (whether lacerations or iatrogenically induced incisions).

We started with elliptical incisions -- almond-shaped cuts down through the skin layer in an outline, then cutting out all the tissue in the center.

Here's one nice thing about pigs: they have lots of extra skin. Which is good when you are trying to close an elliptical incision for the first time.

Actually, it went fairly well. If I'm being modest (okay, I'm not), my elliptical incision was absolutely beautiful when I was done. I did a simple continuous subcutaneous suture pattern, with 2 or 3 skin cruciates thrown on top to close the bits that didn't appose as well as I'd hoped.

Next we were supposed to learn how to correct "dog ears" or "puckers." We did that by creating a half-circle incision (straight across on one side, with a half circle connecting the 2 ends of the straight line). Normally with that kind of incision, you'd want to space your sutures closer together on the straight side and farther apart on the curved side, to gradually take the slack out of the tissue a little bit at a time. But since we wanted to create a dog ear, we just sutured it straight across so we had a nice little pucker at the end that had nowhere to go.

Then we got to practice some techniques for fixing puckers, namely cutting out a triangle of skin to make it lay correctly, or doing a couple extra incisions to make the main incision end at a right angle.

Finally, we practiced advancement flaps. We created a rectangular "wound" but left one side of the tissue connected, so that there was a rectangular flap you could pull up. Then we cut out part of the flap, so that we would have to practice getting the smaller-than-desired flap to align with the larger original incision. That involved a couple of extra triangular incisions, and a lot of creative suturing.

Think that sounded fun? Here's the plan for tomorrow:

Cut open our pig's abdomen (different pig) and cut out its spleen. Hooray!