Page 2 Page? MEDICAL COLLEGE Pay Raise Request Student Pulse GEORGIA The Health Sciences University of the State of Georgia iiiiiBeeperiii Wednesday September 15,19931993 Medical College of Georgia Volume 4, Number 1 Abdominal-Wall Cover Found Effective for Adults Torn Baker An inert plastic sheet presented in Hong Kong. makes it strong so it won't rip need even more fluid to keep that will not suffice. "Wet - used to temporarily cover Dr. Howdieshell is a 1982 apart, but the silicone rubber blood pressure up and dressings will stick to the gaping holes in babies' graduate of the MCG School makes it inert and imperme­ organs working. outer lining of the bowel, abdominal walls also helps of Medicine who also able." "Swelling can be immedi­ no matter how wet you adult trauma patients, say completed his surgery The adults treated with ate or can occur at subse­ keep them.... Then when trauma surgeons at the training at MCG in 1987 the mesh had injuries result­ quent operations," Dr. you go to take those off, it Medical College of Georgia. before going to the Univer­ ing from traumas such as Howdieshell said. "In most will irritate the outer A study of 36 patients at sity of New Mexico for a gunshot wounds or automo­ patients it occurs immedi­ covering of the bowel." MCG's Regional Trauma trauma fellowship. bile accidents. They were in ately and is progressive." Enough irritation means Center showed no compli­ "Not only do their arms shock, bleeding profusely, The result is that there perforation. "It's a disas­ cations from the use of this and legs swell, their intesti­ and needed immediate high simply isn't enough tissue to ter," Dr. Howdieshell said. paper-thin silastic sheeting nal tract massively swells. volumes of fluid and blood cover the swollen intestinal For other patients, as a temporary cover to You try to close the abdomi­ products to sustain their tract. But the gastrointestinal even if swelling resolves protect the delicate, moist nal wall back over this blood pressure and organ tract, which needs an relatively quickly, there environment inside the intestine and you can't do it," function, Dr. Howdieshell extremely moist environ­ may be other major abdomen. The sheeting was Dr. Howdieshell said. "If you said. ment, cannot be left exposed injuries, such as head used for patients whose try to force the wall shut, the But ironically, shock also either. trauma, that make it abdominal walls became increased pressure can sets in motion a host of "If you leave the gastroi­ impossible to take the difficult to close after compromise breathing and inflammatory responses; one ntestinal tract exposed to air, patient back to surgery and massive internal injuries cause the kidneys to fail." of them makes the capillaries it will become irritated, dry cover the gastrointestinal resulted in extensive In his tenure as a trauma more permeable. So these out and perforate," Dr. tract for several weeks. swelling. surgeon, he's tried many patients get huge volumes of Howdieshell said. Even if wet In addition to the direct Findings on this select approaches, including fluid and blood products that dressings are used to cover protection provided by group of critically ill cutting up large, plastic eventually flow into capillaries the area and someone patients were presented at intravenous bags, to find a from which they can easily literally stands at the bedside Please see "Abdominal," the International Society of safe, effective closure to escape. That means patients constantly adding moisture, page 2. Surgery's International keep the delicate gastroi­ Surgical Week 1993 Aug. ntestinal tract safe until 22-27 in Hong Kong. swelling subsides. "In this very select He thought of the Symposium to Explore Tissue group of trauma patients, silastic sheeting because of the blood loss is so massive pediatric surgeons' experi­ that it took large volumes of ence using it to temporarily Glues fluid and blood products to cover the gastrointestinal resuscitate them and tract of babies born without Toni Baker maintain their blood sufficient abdominal wall. "Symposium on Surgical surgery; plastic and recon­ cal Center in Charlot- pressure and organ func­ "It's almost like a piece Tissue Adhesives," a forum structive surgery; craniofacial tesville will discuss tion, (resulting in) a of plastic," Dr. Howdieshell to explore the biochemical, surgery; and peripheral nerve "History of Tissue syndrome called visceral said. "It's actually a piece of biological and clinical surgery. Adhesives." Dr. Gerald edema," said Dr. Thomas R. dacron mesh that is rein­ effects of tissue glues that Course directors are Dr. Marx of the New York Howdieshell, MCG trauma forced with silicone rubber. can be used instead of pins Renato Saltz, plastic and Blood Center will discuss surgeon and principle If you pour water on it, it and sutures to repair the reconstructive surgeon at "Fibrin Sealant Biochem­ investigator of the studies bounces off. The mesh body, is set for Oct 8-10 in MCG, and David Sierra from istry." During a panel Atlanta. the Department of Biomedi- discussion of adhesive The symposium, the cal Engineering at the technologies, Dr. Keith U.S. Postage University of Alabama Green, Regents professor TRAINOR, OONNA J first to feature national and at LIBRARY PAID international experts on Birmingham. of ophthalmology at Permit No. 210 biological glues, is spon­ Dr. Daniel Marchac of MCG, will discuss A8-120 "Marine Adhesives." 4400 Augusta, GA sored by the Medical the College de Medecine des College of Georgia Division Hopitaux de Paris will give an For information or Non-Profit Org. of Plastic and Reconstruc­ "Overview of Clinical Applica­ registration, call the tive Surgery and will be tions." MCG Division of Con­ held at Hyatt Regency Other presenters include tinuing Education at exL Atlanta. Dr. William A. Fricke of the 1-3967 or the Division of Experts win discuss Food and Drug Administra­ Plastic and Reconslruc- experimental and clinical tion, who will discuss "FDA tive Surgery at ext 1- applications of tissue glues Approval Processes." Dr. 6945. in surgery of the ear, nose William Spotnitz of the and throat; cardiovascular University of Virginia Medi­ Wednesday September 15,1993 Medical College of Georgia Page 2 Salary Request Set at 4 Percent Editor's Note: The following The state's financial merit. noted that the governor and that outlines a number of is reprinted from the August condition in recent years The board's budget general assembly have not possible directions for the edition of The System has held the system's pay proposal also seeks $1 billion yet adopted it. system, including a coordi­ Supplement, a monthly raises to 2 percent and 3 for resident instruction, a In other board news: nated structure of institu­ report of the University percent in fiscal 1994 and 15.6 percent increase over The regents selected tions to serve clearly System of Georgia Board of 1993, respectively. Lawmak­ the $871.5 million funded Blue Cross/Blue Shield as defined regions. Regents. ers allotted 1.5 percent for this year. the new administrator for Though the regents faculty and no increase for For the fourth straight the university system's took no action on the With the intention of staff in fiscal 1992 and year, the regents submitted revamped health benefits proposals, the planning being "realistic" with state approved 4 percent in­ a separate budget request plan, which covers all 34 committee directed the lawmakers, the University creases from 1988 to 1991. using their revised funding institutions. chancellor's staff to prepare System of Georgia Board of If funded, the fiscal 1995 formula, which proposes a The regents' planning a series of maps showing Regents voted to request pay raise request would not 37 percent increase in and oversight committee is how the state might be funding for a 4 percent guarantee a 4 percent instructional funding for discussing the possibility of carved into regions for salary increase next year for increase for all employees fiscal 1995. the system's biggest struc­ higher education to be the system's faculty and but would provide a pool of The board is still hoping tural change since it was delivered more efficiently. staff. funding equal to that that the revised formula will founded 62 years ago. The The request which ws amount. As in past years, be phased in, although committee reviewed a 42- submitted with a $1.1 billion raises would be awarded on Chancellor H. Dean Propst page document in August budget proposal for the system in fiscal 1993 is the lowest raise proposal in at Dining Event to least 16 years and followed ... Abdominal lengthy discussions at two meetings this month of the Benefit CMC (cont from cover)' regents' finance committee. silastic sheeting, it also causes, for reasons that are not At those meetings, "A Taste of Olde Town," a Pullman Hall for an entree clear, a thin protective membrane to grow over the regents debated salary dining and entertainment prepared by chef Kevin gastrointestinal tract, Dr. Howdieshell said. This requests ranging from 3 event featuring a trolley ride Goldsmith, then on to La particularly helps patients for whom swelling never percent to 8 percent before through downtown Augusta Maison on Telfair for dessert goes down sufficiently to close the abdominal wall settling on the 4 percent to a variety of foods prepared prepared by chef Heinz normally, hi these patients, this membrane can be used figure, which was proposed by the chefs of Olde Town, is Sowinski. fias a base for skin grafts to close the abdominal wall. by Regent Thomas F. set for Sept. 29. Proceeds from the If I? "Our intent was to report a large series o^patieiQjs | Allgood Sr.