Surgery with Symmetry

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In the Hollywood Hills, I toasted the start to another great year among friends, including another plastic surgery colleague Dr. Marc Mani. Shortly after my sip of Red Bull, I received a call from the Cedars-Sinai Emergency room.  I was on call for plastic surgery.  A patient was stabbed in the arm in another Hollywood Hills New Year celebration party. The trauma resident sounded a bit frazzled, as he help apply pressure on a pumping artery. He wanted my help, and as a plastic surgeons typically cover soft tissue injury to the arm, I was eager to give a hand. I arrived to the ER shortly after that call, and as they dressing was removed, my white shirt got sprayed by fresh red blood. I had to make a decision whether or not to rush this young man to the operating room. The hand was well perfused, and my suspicion that the vessel injured was not the radial or ulnar artery (the big ones going to the hand), but rather a smaller branch. His arm lay in a puddle of blood, and so I asked for a plastics tray of instruments, new, fresh towels, and an assistant. With pressure reapplied, the arm was elevated straight in the air for 7 minutes. The operating room was notified that we may be bringing a patient in. While his arm was elevated, I gathered the story… Party, some argument, chaos, stabbing… In that order. No other injuries. X-ray was normal. Then, the pressure was relieved, the arm repositioned on a new fresh towel. Voila! No more bleeding. The wound was irrigated, and anesthetized, and briefly explored for any foreign body with my magnifying surgical glasses. Nothing. I observed for 7 more minutes, then sewed up the arm and admitted the patient for overnight stay. The following morning, my good friend and fellow plastic surgeon Dr. Amir Tahernia and I brought him back to the operating room and repaired two tendons. It was a good start to 2011…

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