Day 8 - Surgery #4

Today Daniel is having his 4th surgery since his accident - this day marks one week from his burn. It's been a long 7 days. There are times when I feel like it's been ages since that horrible day; other moments when it seems so near.

This day's plan for surgery is to remove the dead skin on his arms (I originally wrote 'remove his arms' and that shocked the crap out of me when I reread it just now - grrrr) and cover it with more alloskin. They also call it allograft or cadaver skin. The covering will remain as a protective curative cover for his skin until they can harvest and graft his real skin from his legs. Then his arms will be splinted to prevent him from moving his arms much. They can't restrain his arms as easily as they have before because now his arms will have the skin 'covering' and they don't want the wounds disturbed so splints it is.

The first day Daniel came into the ICU they performed a procedure on his burned body called an escharotomy to deal with issues that occur with large 3rd degree burns. He has long incisions down the length of each arm. I've not seen his arms except for a few peep holes I could see where the burns were. I could also see the deep cut where of the escharotomy ran along the outside of his arms up by his shoulder.

By the end of today I believe all his body burns (not face) will be covered with have been cleaned and covered. Next operations will be to begin the grafting - possibly beginning in two days time.

It's impressive that Daniel's body can take all this surgery day after day, but we believe this is the best approach to getting him well. Decades ago the procedures and methods for burn victims were different. In another 20 years time the best practices may have evolved even further. Part of the injury sustained from this bad bad burn is internal. His kidneys took a hit early, but seem to be bouncing back and doing pretty well.

Daniel is fighting some infections and antibiotics are being deployed and tuned to target the specific strains infecting him. He had a fever that spiked last night, but as long as it comes and goes the doctors and nurses aren't overly concerned - they see this more as a sign or type of inflammation than a marker of a serious infection.

Doctors are talking about a tracheostomy in the coming week as an alternative to the airway they have in his mouth. This procedure as I'm learning is a good strategy to get the airway out, but allow for improved breathing for the next stages of his recovery and eventually going off venting completely. The "trach" is not a permanent breathing method (we don't think), but rather just another tool to slowly return him to a normal post-burn life.

There's been a little discussion about his cute perfect ears and whether they will heal on their own and intact or if future surgeries will be needed to remove bits that are too badly burned. That kind of thing is minor by comparison to the rest of his injuries so we will just sit tight on that for now.

So here I sit while Daniel is working hard with the surgeons, nurses and anesthesiologist down on the second floor. (Burn ICU is on the third). Time for a run outside with blog updates to come on today's post later this evening.
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Daniel is back from surgery and resting in his room is a deep slumber. Arms outstretched in his wedges that help prepare his arms and skin for growing into and onto his body. Today's surgery went pretty well, some bleeding and leaks popping up as before, but not like it did two days ago. Daniel will be resting for the next several days while they get him super healthy and ready to do actual skin grafting.

The next few days will have Daniel migrating to a different blend of pain meds that may allow him to be a bit more awake and aware, but at the same time he won't feel a thing!

The surgery team (Team Daniel) did not install splints on his arms like they hinted instead leaving his arms as before so they can easily redress his burns. His wounds continue to be covered in medi-honey and other anti-bacterials.

That's about it for today.