Vocal Warmups – Day 9

The thirty-three thieves thought that they thrilled the throne throughout Thursday.

Research suggests

he was stunned

Mother Smucker would allow no one to tuck her,
Except brother Tucker, who was a Mother Smucker tucker.

Irish wristwatch

After identification of the patient and informed consent, he was placed in the usual supine position.  After induction/intubation with a laryngeal tracheal mask, the patient’s right lower extremity and groin were prepped and draped in the usual sterile fashion with Betadine scrub and paint.  Surgery was begun by anesthetizing the right lower extremity wound, over the medial malleolus, as well as the right groin donor site with 1% lidocaine with epinephrine.  The ulcer was excised with 5 mm margin tangentially using a #15 blade scalpel.  Specimen was sent to pathology for permanent section diagnosis.  Electrocautery was used for hemostasis.  The area was irrigated with saline and then covered with a gauze until later grafting. Template made of defect, and a full-thickness graft harvested from the right groin inguinal crease region along the resting skin tension line.  Full-thickness grafts harvested with a #10 blade scalpel.  Donor site was closed after local undermining using #3-0 Vicryl sutures in Scarpa’s fascia, #3-0 Vicryl sutures for subdermal tissues, and #4-0 Vicryl along the subcuticular layer.  Graft was defatted, cut to the appropriate dimensions, placed in the bed, and secured with running sutures of #6-0 chromic.  It was then covered with a tie-over bolster created using antibiotic ointment, Adaptic, Reston foam and surgical clips.  Right lower extremity was then wrapped with Kerlix, Webril, cast padding, and placed in a posterior splint with plaster and a lightly applied Ace bandage.  Donor site and groin covered with benzoin, Steri-Strips, and sterile dressing.  The patient was extubated and taken to the recovery room in stable condition.  No complications.