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Having left Mike -- in fact com -- pleasure to have you here with S and had the pleasure being giant.
On sat by and esteemed panel of doctors surgeons and fat and they're gonna share went past some of the information they have about working with that.
War time out we have other tenant -- area I think he's back he's been on the program -- -- nice to have you.
Plastic surgeon you also do -- reserve -- -- the national.
Naval medical center we're also joined by lieutenant commander Patrick -- -- -- here with us as well nice to see you.
And by Ian malaria and other lieutenant commander Steve we've got the men and right here today supporters talk about that the work that -- do and kind of to distinguish between.
Working with -- from that and more injuries vs what people may you know come to expect in the normal plastic.
Practice in hospitals hearing it on I'll begin with you -- you can tell me a little bit about you guys have worked together friends later on likeness.
In right so we we worked together I work when I'm there on the -- some reservists these two gentlemen awful time active duty plastic surgeons.
But to your point plastic surgery when you think about it.
On TV is cosmetic surgery but that is far from what we do in -- what most plastic surgeons to actually most of what questions do around the country's reconstruction.
It just doesn't sell ratings on TV for this way don't see it.
But it basically involves moving.
Tissue where you don't need it to areas that you do need.
And with war trauma we just have a large wounds and so we have to move large.
Segments of tissue to.
Cover those large -- and bone defects and other vital structures that are deeper and inside -- you don't normally see on a daily basis so.
That's kind of a big picture of what we do.
All right and so I'm up when he described how the process that timeline of the war went reconstruction because I imagine there's a number of steps.
-- have to be taken and you have to really work with the patient over an extended period of time sang imagine if you're.
Taking tissue in transit there's conflict that it doesn't work right and you have been trying for more tissue.
To put in that area and you're working also with reconstruction but.
So there's -- -- plan and things like that.
Yeah absolutely it's a a big sort of process that starts actually in -- on the -- -- -- injured.
They get a -- there they are treated by forward surgical teams.
Who do -- they tend to stabilize the patient and then taken through.
-- silly like Germany and then we get them on average about four point five days after their initial injury.
At that point we -- them through the full spectrum.
General surgery plastic surgery orthopedics.
It's a big team effort to address every one of their issues.
And then that really begins the start of their reconstruction which -- deeper about a week or two just going back the -- -- every two to three days.
To get reassessed.
Take away -- analyzed tissue and really kind of plan for the ultimate reconstruction which can sometimes.
It happened two to three weeks after their injury I think -- -- time before we do really the definitive being reconstruction.
Is about -- -- -- days which is very different than civilian injuries which they try to get.
Treated them and reconstructed within about two -- Five days after injuries.
Is there any at disadvantage because I was thinking about -- the soldiers out there finding friends and their sense there's a time delay right at the time he sent it in Germany and then.
They see you and perhaps -- 21 days out they're able to get there.
Full you know complete kind of reconstruction he does surgical disadvantage at all for them in terms you know less than.
Recovery process or actually maybe some of -- working better than if they had -- timely fashion.
It intuitively you would think yes but -- actually it's no because.
The conditions of which there injured the blast injuries which are packed with.
And other types of traumatic material.
They really need those multiple wash -- over one -- two weeks to get rid of all immaterial to make it healthy.
And non infectious to go ahead with their reconstruction so I think ahead four point five days from the -- injury to time in the we're seeing them is actually pretty good.
-- -- I -- to hang on about that before where you have to really flush it out clean it out well.
A lot of these antibiotics and things is if you have an infection -- -- -- can do even more you know damage.
-- the existing lands and really I interfere with the healing process.
Thank conversely you could also compromise our reconstructive abilities.
If we -- to provide early coverage -- -- less than optimal settings such as these early infectious events you can actually adversely affect our our definitive reconstruction so.
Oftentimes can control -- wound environment and wound bed for more preferable.
To allow for better -- for our eventual reconstruction.
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