
8:50 a.m. Himel has moved his attention from the woman's chest
to her neck and discovers that the acid has burned all the way
through the dermis on the right side. He carefully slices away
the damaged tissue.
9:40 a.m. Having removed all the dead skin from the chest and
neck, Himel holds the patient's left thigh taut while the
surgical assistant uses an electric-powered device to peel away
two foot-long strips of the epidermis and the upper part of the
dermis from the woman's left leg.
9:50 a.m. As the surgical assistant uses a razor to make tiny
pinpricks along the entire length of each skin strip, Himel
explains, "Pinpricks will allow the fluids and blood to seep out
and any bacterial growth to leave the wound bed."
9:53 a.m. Displaying jigsaw-puzzle finesse, Himel and Polynice
arrange and rearrange the strips over the patient's neck and
chest, trying for a placement that will leave as few visible
seams as possible. Finally they decide on two strips laid
lengthwise, beginning under her chin and ending at the base of
her neck.
9:57 a.m. Polynice begins stapling the grafts to the adjoining
healthy skin. In tricky areas, he resorts to tiny steel clips
that he squeezes closed with surgical forceps.
10:10 a.m. Himel decides he wants to graft two separate pieces
of skin onto the woman's chest so that they meet in a seam
between the breasts. He is concerned that a single band of skin
might contract when it heals. Needing more skin, he measures for
it by placing a piece of gauze over the remaining uncovered area.
10:30 a.m. Using skin sections taken from the patient's inner
thigh, Himel deftly sutures the pieces together on her chest.
10:35 a.m. The surgical assistant places wound dressings over
the donor sites on the thigh, which should heal enough in two
weeks to provide additional donor skin if needed.
10:50 a.m. Winding down the procedure, Himel injects a saline
solution under the skin grafts to irrigate the wounds before
nurses cover them with an antibiotic and a gauze dressing. He
takes his final photos of the grafted areas, which are now
neatly covered with skin lined by shiny staples.
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