TRAMtastic!

I started 4th year on plastic surgery 4 days ago, it has been a blast! I remember not being able to sleep on Monday night from the excitement and worry about the grueling grillings that the consultants may do to me. But so far the people had been friendly, the two regs I met on the first day are rather indifferent to my presence, but on the third day another reg joined our rank, and she has been nothing but friendly and approachable.

Apart from the early ward rounds, all-day clinic on Thursday, I've been living in the theatre. There were a lot of holding hooks and cutting sutures but eventually, hang around long enough, they throw you a scrap once in a while. I got to cut out a BCC on Tuesday, and today, sutured a belly button.

I got to assist in a free TRAM flap today. TRAM stands for transversus rectus abdominus myocutaneous flap. It means taking the fat and skin of the abdomen to reconstruct a breast for those underwent mastectomy. It is a major operation, took us from 9am to finishing at 6pm with about 30 minutes break in between. It took every bit of concentrations to dissect away layers of skin, fat and muscle, all the while keeping an eye out for the blood vessels as we were trying to harvest them. Then about 2 hours of micro-surgery anastomosing the artery and vein that were about 3mm in diameter with 9/0 sutures that were about 50% thinner than hair. Follow by urning the tummy flab into breast, and lastly stitch everything up.

Being a good boy that I am, I got to suture the new belly button for the patient. She was worried about whether she will still have a belly button yesterday when we saw her pre-op. I will have to ask her how she likes her new belly button when I see her next.