Plastic Surgery News

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Plastic Surgeons Face Unexpected Challenges In Emergency Departments

Cornelious Hickman arrived at the emergency department of Genesis Medical Center, East Rusholme St. with injuries suffered when he was attacked by three dogs.

The young man's injuries were not life-threatening and he was awake and alert but he had a nasty gash on his face and his hand and arm were badly injured.

Hickman's treatment wasn't limited to nurses and the emergency room physician. Soon after Hickman arrived, plastic surgeon Anne Cramer, M.D., was called to assist.

She entered Cornelious' treatment room in street clothes - not the white coat of a doctor - and began to explain what she wanted to do to prevent Cornelious' injuries from scarring worse than was necessary. Cramer said she learned early in her career to not wear a white coat when kids are involved.

"They immediately begin to wonder what is going to happen and whether it will hurt," explained Cramer, who at one point in her career was the medical director of a burn unit that dealt with all age groups.

"She came in and told Cornelious exactly what she wanted to do for his injuries," said Constance Hickman, Cornelious' mom. "She made Cornelious feel at ease about the surgery. We're very happy that she was there and his injuries are healing very well because Dr. Cramer was available."

In three hours of orthopaedic and cosmetic surgery, Cornelious' damaged hand and arm were repaired. He will continue to be a patient of Dr. Cramer for the next year or more to monitor his scars.

Cramer is one of four plastic surgeons who respond to the emergency departments of Genesis Medical Center in Davenport and in Silvis to repair injuries suffered from accidents and trauma events.

The plastic surgeons have come to expect the unexpected.

One night they might repair a bad laceration caused by a fall. Another call could be to repair an injury suffered by a child who has been in an automobile accident.

They see dog bites, which are common, knife and gun shot wounds, and complex facial injuries.

Cramer and John Searles, M.D., along with Ben VanRaalte, M.D., and James Paul, M.D., alternate weeks providing plastic surgery coverage to the emergency departments.

"It's a great service to our patients to have four highly skilled plastics surgeons available when they are needed," explained Joseph Lohmuller, M.D., trauma surgeon and trauma director of Genesis Medical Center, Davenport. "They aren't doing this for financial gain. They do it because it is important to the patients."

The financial gain can be very limited if a patient is not covered by health insurance.

"It is challenging because of what we see, and rewarding because we are helping people," Searles explained. "You provide these services because of the good you can do, not because it is financially rewarding."

The challenge for the plastic surgeon providing coverage to the emergency department can vary from day to day.

"That is what makes it interesting. It can range from the complicated to the routine," Searles added.

The plastic surgeons also supply another important service to Genesis patients. Women who have a breast removed because of cancer have the option of having a breast reconstruction at the same time.

"It makes sense to be able to do breast reconstruction at the same time as a breast removal and it's a very important service we can offer to women who are going through breast cancer," Lohmuller added.

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