Posts Tagged ‘observation’

Plastic Haikus

When I was a hand fellow in Louisville, one of my fellow slaves, as we were called, was Douglas Halsted, who was a great nephew of William S. Halsted, the father of modern American surgery. Douglas once made the insightful observation that hand surgeons were like ‘old fashioned’ auto mechanics in their requiring skills in both diagnosis and repair of parts as opposed to routine replacement. While driving to the hospital last Saturday morning I was listening to Car Talk, a program on our public radio network. This is a humorous program in which two MIT educated brothers, who own an auto repair facility in Cambridge Massachusetts diagnose and recommend treatments for the various ills that plague the cars of the listeners who call in. This past Saturday they had a segment on ‘Auto Haiku…

Surgical versus pathological excision margins—an excision too far?

Abstract  A common observation by clinicians who surgically excise skin pathology is the discrepancy between the measured size of the
surgical specimen and that of the measurements reported by the examining pathologist. This discrepancy can often be the difference
between whether, in the case of skin malignancies, the patient requires further wider excision, follow-up and, in cases where
relevant, discharge. Could it therefore mean that patients are needlessly undergoing further excisions that could be avoided
with more careful attention to specimen measurements and specimen ‘shrinkage,’ both surgically and pathologically? We measured
the length and width of skin lesions excised pre- and post-operatively and compared these measurements with the reported histopathological…