Saturday, July 11, 2009

Another Day at Work...

Good Evening Everyone,
As we are all packing to come home, I noticed that I had some pictures that I wanted to post and clear off my hard drive. Tasha took these photos for me, so thank you Tasha, you are the 'Bomb Dog Diggity' (That means you are awesome).

Well, a few days ago I had an Iraqi who had come in to see me for a medical problem and while he was in the interpreter told me that this young man had a growth on his abdomen that he wanted me to look at. I examined him and it appeared that he had a dermatofibroma or some kind of vascularized lesion. So, I went ahead and removed it for him and sent it to Germany for lab confirmation. Below are the pictures. A side note, I hadn't published a picture of Drew Porter. He is a sports medicine physician. He is a really great guy and a super fitness freak. He works out 2-3 times everyday. He has since left us and headed home to Iowa. We miss him.

Dr. Drew

Here I am preparing to outline my cut lines. I used an eliptical excision. Generally, the width of the incision should be three times longer than the height. This rule ensures that the wound will close with as little tension as possible.

Lesion is prepped with betadine

I am using a local of 2% lidocaine with epi. The epi will help to minimize the bleeding during the procedure.

I have made my incision and am close to completing the excision.

Almost done.

This is a cautery pen that I use to stop the blood vessel from bleeding.

The nodule has been removed. I will now undermine the healthy tissue on the edge of the wound so that the wound edges approximate well and with very little tension.

Getting ready to close.
I have started suturing with a 5-0 Prolene absorbable suture. These will dissolve and be absorbed by the body. Internal sutures helps to keep the wound tension low so that the external sutures do not pull free.
SGT Beechler and SPC Gravitt are giving me a hard time. I get picked on alot by my guys. It's like junior high school all over again. I gave them extra duty and made them guard a cactus for 8 hours. :0)

Here the wound edges are well approximated with internal sutures. Now, I am ready to place the outer sutures.

Here I am utilizing 3-0 Ethilon, non-absorbable sutures to close. These sutures will have to be removed in 7-10 days.

All finished. The patient did great. The local Iraqi's are really a fine group of people. They are so thankful for the things that we do for them. Taking care of soldiers and local villagers is very fulfilling for me.

Thank you all, again, for checking in. I pray that you are all well.

God Bless You,


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