Word: skinning
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...depend utterly on healing - unexplainable, amazing, taken-for-granted automatic mending of cut skin - for any and every success we can possibly have with any surgery. We rely on it much as a farmer depends on his hard, dry seeds to turn into green plants, but our need is a little more intense: If the healing miracle fails, what I accomplish in surgery is only to hurt someone who came to me for help. And I'm likely to feel more than emotional pain - plenty of juries can be convinced that an un-healing wound is sure evidence of malpractice...
...medical shows can be pretty goofy, especially when you're a surgeon. Always amusing, to us anyway, is the great drama of the skin incision. This much you should know about real surgery: The skin incision is the easiest part. Human skin cuts about like a pork chop (or a Fruit Roll-Up, if you're a vegetarian); a scalpel is usually no sharper than a good kitchen knife. Knowing where and how deep to cut is also super-basic to the practice of surgery, about like starting the engine is to the practice of driving. The skin is (unless...
...healed when he came to my office a week afterward to get his stitches out. So I had him come back a week later, then two more weeks later. The knee joint was ok but at the fourth week I was still staring at two gaping holes in unhealed skin. They were like cuts on a cadaver; it was creepy. There didn't seem to be a reason for this failure of his skin to close. His pre-op labs had been normal. I went through our old mnemonic - FRIEND - but there was no foreign body, radiation, infection, enteritis (like...
...idea came to mind. Because openings into joints can let bacteria in, I had kept Manuel on oral antibiotics. But I recalled an experiment done with lab mice bred in a sterile environment. Without any bacteria around they couldn't heal cuts in their skin. Maybe my antibiotics were suppressing some bacteria that were needed to coax these knee wounds to heal. So I stopped the antibiotics and brought Manuel back a week later. No dice - still no change...
Most cases of MRSA outside health-care settings are mild, appearing as red, swollen pustules on the skin, and can be controlled with antibiotics other than ones from the penicillin family. These cases are usually not the so-called invasive infections--those that enter the bloodstream and can damage tissues. Last month, however, the Centers for Disease Control (CDC) and Prevention released a report on invasive MRSA estimating that in 2005, there were 32 cases per 100,000 people in the U.S.--a troublingly high number--and that 14% of these occurred in people with no documented history...