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Terry Streetman (Host): Welcome back to Well Within Reach, presented by Riverside Healthcare. I'm Terry Streetman, marketing and communications representative, and we're here today with Dr. Alec Fisher, Riverside plastic and reconstructive surgeon, and we're going to talk about microsurgery, which is a technique that can help treat complex wounds and trauma. So thanks for joining us, Dr. Fisher.

Alec Fisher, MD: My pleasure. Thanks for having me.

Host: Before we get into our questions, we'll take a quick break for a message about MyChart.

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Host: Okay, we're back. Dr. Fisher, we've had you on the podcast before, but can you remind our listeners about your background and your role here?

Alec Fisher, MD: Absolutely. I'm a plastic and reconstructive surgeon. I treat a lot of complex wounds. I also, do cosmetic surgery. I trained on the East Coast mostly. I went to Dartmouth for medical school and I did my six year advanced training residency at Cooper University Hospital, which is just outside of Philadelphia.

It's a level one trauma center. And, MD Anderson Northeast Cancer Center.

Host: Awesome. Thank you for that. So, let's get started here. You know, I mentioned microsurgery. I don't know that a lot of people are familiar. Can you explain microsurgery in, I guess as simple of terms as possible for our audience?

Dr Alec Fisher: Yeah, absolutely. Microsurgery refers to a large array of different procedures that involve connecting blood vessels together. So, it's called microsurgery because you're using blood vessels that are very small and you have to wear special glasses or a microscope in order to stitch the vessels together.

And the suture or the stitching stuff that I use is finer than human hair. So it, requires a lot of delicacy and care. So that's why it's termed microsurgery and it really refers to a large variety of procedures. But the big thing that microsurgery allows you to do is it allows you to take tissue from somewhere that it's expendable.

For instance, a common place I may take tissue from is the abdomen or the thigh, and then I can move that tissue anywhere in the body where you need the tissue and then I can connect the blood vessels that go to that piece of tissue, on the, let's say I take the thigh, I can take the blood vessels that go to that skin on the thigh and then connect them anywhere else in the body where it needs to be kind of hooked up and plugged in in order to, to solve a problem.

Host: Wow. That is incredible. And maybe a little too advanced for my brain to understand still, but that's okay. I don't have to understand it exactly. So with microsurgery being such a specialized, advanced technique, what does that mean then for patients and families in our community to have this available?

And, as I understand it, this is a pretty new thing to have available here. Can you explain that?

Alec Fisher, MD: Yeah, absolutely. So I'm the first microsurgeon at Riverside. As far as I know, there's nobody who offers microsurgery between Chicago and Peoria. So, it's really nice that I can bring this to the community.

And what that means for the community is that I can treat a larger variety of really complex problems that normally would have to go to another healthcare system. The two big areas that microsurgery is really involved or helpful in is, breast reconstruction, for one. I can take a woman's own tissue, particularly from the abdomen to reconstruct the breast after, a mastectomy or where the breast is removed for cancer. And the other big thing is if, somebody suffers a big trauma or has to have a lot of tissue removed because of cancer, and that wound can't heal on its own, I can use microsurgery to bring tissue into that wound and have it heal.

Host: Wow, that is amazing. And it's so important for those kind of situations.

We're really glad to have that available here. So you talked about, the traumatic injury. When someone suffers an injury like that, how does microsurgery help if you can explain in more detail with the treatment, the recovery process, and even with those breast reconstructions, what, can you explain to us on that?

Alec Fisher, MD: Yeah. Some wounds will never heal depending on the wound. Particularly if you have a wound where there's exposed structures, like let's say somebody suffers a big car accident, and they have a traumatic wound to their leg and the bone's sticking out, and the orthopedic surgeon has to put the bones together and then they'll use, hardware or plates and screws to try and put the bones back together.

And if the trauma is so bad that the skin and muscle can't cover that hardware; it'll get infected if it's just left open to the air, and then they'll have to remove all the hardware and then that bone will never heal. And then sometimes that can result in an amputation of the leg. Where I come in is, once we know that there's not enough tissue to cover the bone or the hardware, I can bring tissue from somewhere else, safely cover it and preserve the leg so somebody can save their leg after a traumatic injury.

But the beauty about microsurgery is this technique can be applied to anywhere on the body. So I can do this for big wounds of the scalp or the face, or the arm, or the leg or the back, or the abdomen even. It really doesn't matter where the wound is, because I can figure out a way to take tissue from somewhere where it can be donated and give it to somewhere where the body really needs it to heal.

Host: Wow. I imagine that means so much and makes such a difference for folks in these situations, not just for the medical reasons, but to make them feel better and feel, that they don't have these big wounds. And I'm, sure it heals better too.

Alec Fisher, MD: Yeah, absolutely. This will definitely heal better. It's always good to try and use somebody's own tissue to heal these wounds, rather than, using an implant or a product to heal these wounds. And also it allows for a large volume of tissue to be available to treat the wound. So I can really make a big difference in, in people's lives and, save extremities if need be, if somebody suffers a big enough trauma.

Host: Okay, before we move on to our next questions, we're going to take a moment to talk about the importance of primary care. Consistency is being able to count on someone to be there when you need them. At Riverside Healthcare, your primary care provider is dedicated to being in your corner, helping you and your family stay healthy and thrive.

Find the right primary care provider for you at myrhc.net/acceptingnew. From annual screenings to well checks and everything in between, having a primary care provider you can trust makes all the difference.

Okay, we're back to our questions here. How does microsurgery then impact the recovery timeline and the results for the patients?

Alec Fisher, MD: Because we're treating these complex wounds, some of them may never heal without microsurgical intervention. So it's hard to say exactly on the timeline. Obviously, there is a recovery period after a big surgery like this where we're shifting tissue around the body. Typically I quote patients three to five days after most microsurgical procedures that you're in the hospital recovering.

But the idea is we're preventing wounds that will never heal. In terms of the results, there's a principle of plastic surgery where we try and replace like tissue with like tissue, meaning I try and make the results as natural looking as possible, and I think also being a cosmetic surgeon plays an important role here because I'm not going to do something that looks extremely abnormal.

I'm going to try and make things look as good as they possibly can based on what the initial trauma or injury or cancer was.

Host: That's great. And I think that confidence and quality of life that comes from that, for folks who have been through such a difficult, experience means a lot to them.

Alec Fisher, MD: Yeah, it's, it's extremely meaningful to me, to try and bring people as close to normal as possible. And, I think it's exceptionally rewarding.

Host: So with Riverside being a comprehensive health system, we have all these different providers and all these different specialties. How does that make the recovery process more seamless if people need, you know, from these traumas like, occupational therapy or any other kind of assistance.

Alec Fisher, MD: Absolutely. I think it's really nice that we have a comprehensive medical system. So, I play just a small part in a greater team where I can do these complex surgeries, but I count on the ICU or the nurses to take care of these patients after surgery and we keep in close touch. Additionally, some of these surgeries may require me to work with another surgeon. For instance, if somebody has breast cancer, I work very closely with the breast surgeons, in order to take care of that. I also work with the trauma surgeons to take care of those things and see what my role can be and how I can help. And then beyond that, after the patient's recovering in the hospital, you know, I always have physical therapists evaluate my patients to make sure that they can go home safely, that they have what they need to succeed at home, additional occupational therapy can see them.

And there's also, a lot of mental trauma or changes that can happen with these severe injuries or changes to the body. So I like to have, therapists talk to my patients and see if there's any needs that they could benefit from in that recovery process. Because this is not easy.

And I recognize that, and it's kind of one of the best parts of my job is making this difficult pathway a little bit easier to walk.

Host: That's awesome. Yeah, and we're really proud, I think, here at Riverside that we have that whole array of services and that the MyChart system helps keep all that in one place.

So, we're glad to have you as part of that.

Alec Fisher, MD: Yeah. Happy to be here. And it, it's an awesome system to work for.

Host: Awesome. So we're almost to the end here. So what is it that excites you most about bringing this technique and capability here to our community?

Alec Fisher, MD: I think that I can provide really comprehensive plastic surgery services and keep patients here. Their families live here. Their loved ones are here. They want to be seen by their support network when they're in the hospital. And we can do these procedures that normally would be done at bigger centers. We can do them here and, and make Riverside one of those bigger centers.

 So it really brings me a lot of pride to bring these techniques here to this community and, expand the scope of patients that Riverside can treat.

Host: That's great. We love having that advanced care close to home for the folks we serve. Okay, so we're at the end here. A question I always like to ask is, what is the biggest takeaway from our listeners? If they take one thing with them, what should that be?

Alec Fisher, MD: That microsurgery is a complex procedure that really involves a lot of care both on my part and the patient's part and the whole team's part, and that we're happy to bring this service line to this community and take care of the patients here in this area.

And I think that we'll be able to keep a lot more patients here in the Riverside healthcare system so that they don't have to go somewhere else or travel very far and put that taxing toll on their support network.

Host: Oh, great. Thank you so much for that. And thank you for joining us here today.

Alec Fisher, MD: Thanks. It was a pleasure being here.

Host: Alright, anytime. For our listeners, if you want to learn more about Riverside's Plastic and Reconstructive Surgery Services, you can visit myrhc.net/plasticsurgery. Thank you for tuning into Well Within Reach, presented by Riverside Healthcare. Please take a moment to rate and leave a review for Well Within Reach on Apple, Spotify, or wherever you get your podcasts.

To learn more about Riverside, visit riversidehealthcare.org.