Welcome to the 10th edition of SurgExperiences, a blog carnival dedicated to all things surgical. (And apologies for the late appearance; I realized at work tonight (where blogs are blocked from computers) that this was the important event I’d forgotten about when my days and nights got mixed up.)

The posts from our contributors this edition are so fascinating that I am sure you will enjoy them despite the lack of any fancy graphics here.

First, my favorite: Bongi’s tales of the black mamba. Read on to discover what dangerous anatomical structure he’s referring to. Also from Bongi (guest posting on All Scrubbed Up) a hilarious post on the realities of life in the OR.

Surgical education and error
Orac explores a recently published study of surgical errors showing more errors are made by experienced surgeons doing common operations (not necessarily junior surgeons just learning the operations).

A journalist comments on the difficulty of accurately measuring the number of wrong-site surgeries.

Buckeye Surgeon presents a case of wasted resources on the road to definitive surgical treatment. Orac expands on this with a scathing indictment of surgeons’ refusal to be involved in anything which doesn’t directly lead to cutting on a patient as a source of inefficiency in American healthcare. As an old-fashioned advocate of the surgeon being responsible for pre- and post-operative care, I echo the commenter who remarked that internists are ill-fitted to be responsible for the medical management of surgical
diseases, since they’re not trained to recognize when the patient has failed medical management. I recently saw a similar scenario play out, where a patient was admitted and had a million dollar workup for possible cardiac origin of epigastric pain. He returned to the ER the next day with excruciating epigastric pain, which yours truly recognized pretty quickly; a simple set of liver enzymes and an ultrasound revealed the gallstones which were the true culprits. So much for medical management.

Buckeye Surgeon also meditates on the complexities of educating residents.

From beyond the blood-brain barrier
A reminder from our anesthesia colleagues that good anesthesia counts.

Terry at Counting Sheep presents a lament for abandoned elderly people being “treated” by surgery that can do nothing to truly help them.

A tale of chaos in the OR that trumps any I’ve heard yet – glad I’m not working at that hospital.

From the front lines
A picture is worth a thousand words: military surgery in Iraq.

From the inimitable Dr. Schwab, an essay in fiction which leaves me shaken. Dr. Schwab explores possibilities I’d rather leave in silence.
Also, a collection of his best real-life stories.

Plastic surgery weighs in
Educational summaries by Suture for a Living on extravasation injury from chemotherapy agents, and on the potential for skin necrosis from the use of methylene blue dye in identifying sentinel lymph nodes during breast cancer surgery.

From another plastic surgeon: a discussion of how much bariatric surgery vs. plastic surgery can contribute to decreasing the morbidity associated with obesity.

Medical education
Jeff at Monash Medical Student makes plans to not faint during long cases. For his encouragement, I will admit to coming close to fainting during burn cases. (Ok, so you try turning the temperature up to 85 F, putting on a long paper gown, covering your face with a nonpermeable paper-and-plastic concoction, holding a heavy extremity motionless for twenty minutes, and see if you don’t get orthostatic.)

On a similar note, advice for medical students on what to do when scrubbed in.

Thank you for visiting. I hope you’ve enjoyed this collection of surgical blogs. The next edition of SurgExperiences will be hosted by Buckeye Surgeon on December 23. You can view past editions of SurgExperiences here, and if you are interested in hosting a future edition, you can find out more at that site. (I highly recommend hosting this carnival, if only because it obliges you to read all of the posts. I discovered several fun new blogs this way.)