The Skin We Live In

Now that we know what changed inside, what is going on outside post-surgery of the implanted neural prosthesis?

On a daily basis, we are exposed to all the things that can make our skin look better, more radiant and younger. Some of us spend hours on skin treatments, tanning salons, botox injections and even laser hair removal. You hear those advertisements. We just want to look better than what we see reflected in the mirror every day. The reality of it is that all of that doesn’t matter when there is a real medical issue involving your skin.

While gaining consciousness in the recovery room, a sweet nurse, Anna, gave me a fresh blanket just out of the warmer and two things came to mind: I am damn thirsty and why am I not feeling a ton of pain? Let’s put this into perspective. I felt sore and beaten up like I had just paddled a distance race in a kayak on rough waters. But it wasn’t that over-taking post-surgical pain. It’s a good thing.

That slow progression toward consciousness, you start to look around and ‘register’ where you are and what happened to you. You almost feel like an infant who is unable to talk but taking in all the sights and sounds around you trying to make sense of it all. There is the IV to the left and some other fluid leading to a needle in my left hand. To the right is the heart monitor and there is an oxygen sensor on my right finger. Then, I’m looking at my skin. The lighting isn’t all that good but it appears that I aquired a ‘Trump tan’. That’s right, I was orange from the the povidone-iodine surgical wash.

Our skin is not only the largest organ of the human body but it’s also one of the dirtiest. Millions upon millions of bacteria live on our skin; which is referred to as the skin microbiota. Some of the bacteria is good as it helps our bodies fight disease-causing microbes but others can be deadly. Hospitals are common places to get exposed to such fierce microbes. MRSA, for instance, has been recognized by the CDC as a cause of skin and soft tissue infections and remains at a high probability in the community particularly for those with surgical incisions.

In a 2008 peer-reviewed publication, Review of Urology, “surgical site infections complicate an estimated 5% of all clean-contaminated operations performed annually in U.S. hospitals and accounts for the most common nosocomial infection in surgical patients. Patients who develop SSI (soft tissue infections) have longer, costlier hospitalizations and are more likely to spend time in an intensive care unit, are 5 times more likely to be readmitted and are twice as likely to die.” Back in 1999, the CDC issued guidance and recommendations for the predisposition of infection including the use of antimicrobial prophylaxis as well as the use of antiseptic agents for skin preparation.

Thus, the Trump tan. The color of choice that day was orange. The morning of surgery, I was required to take a shower using an antiseptic/antimicrobial skin cleanser, commonly known as Hibiclens, to help minimize the skin microbials. Even prior to the first surgical incision, the team washes the subject down with PVP-I. It stays on the skin until you are cleared to take a typical shower with good old soap and water.

At this point, the surgical team’s job complete and my job now begins. Unlike the implantation of electrodes, the placement of the new receiver does not require restricted movement to allow the body to encapsulate the new device. However, limited movement is required to not distrupt the internal and external stitches of the incisions. Mainly, it comes down to wound management of the new seven incisions and remaining vigilent against infections as they heal.

With five of the seven incisions in my pelvic region, my belly looks like one big gauze pad. For the next week post-surgery, each shower is accompanied by this smelly pink Hibiclens wash to clean any skin microbials. Each day is a laborious project of carefully taking off the previous day’s dressings, cleaning the incisions and replacing the coverings for another day.

On the skin’s surface of each incision is surigcal glue. It is literally medical grade super glue that holds the incision together. After a few weeks, the routine will shorten and the incisions will begin to heal. The glue will peal away leaving the only evidence, surgical scars. Or as I refer to them, my tatoos of life.

Note: The statements and views posted here are of my own and do not reflect those of Case Western Reserve University, the Department of Veteran Affairs, Metro Health Medical Center or the National Institutes of Health along with their representives involved with this program. If you are interested in this clinical trial, please visit and search NCT00623389 or NCT01923662.

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