{"id":54171,"date":"2018-08-22T14:43:00","date_gmt":"2018-08-22T18:43:00","guid":{"rendered":"https:\/\/huntsville.dopperonline.ca\/?p=54171"},"modified":"2018-08-22T15:15:33","modified_gmt":"2018-08-22T19:15:33","slug":"plastic-surgeries-requiring-special-equipment-being-moved-to-bracebridge-hospital-site","status":"publish","type":"post","link":"https:\/\/doppleronline.ca\/huntsville\/plastic-surgeries-requiring-special-equipment-being-moved-to-bracebridge-hospital-site\/","title":{"rendered":"Plastic surgeries requiring special equipment being moved to Bracebridge hospital site"},"content":{"rendered":"<p>It seems Muskoka Algonquin Health Care\u2019s much lauded and newly implemented<span style=\"text-decoration: underline;\"><a href=\"https:\/\/doppleronline.ca\/huntsville\/mahc-adds-plastic-surgery-to-surgical-specialties\/\" target=\"_blank\" rel=\"noopener\"> plastic surgery program<\/a><\/span> has hit a bit of a snag.<\/p>\n<p>That is because Dr. Oleh Antonyshyn, the plastic surgeon brought on board on a locum basis for the program, prefers to use a method referred to as frozen section for certain surgical procedures, particularly as they involve facial areas.<\/p>\n<p>Frozen section involves rapid tissue analysis by a pathologist while the patient is still in the operating room. It requires the support of a pathologist, specialized laboratory services and a cryostat\u2014all of which are located, and operate out of, the Bracebridge hospital site.<\/p>\n<p>While the pathologist works out of the Bracebridge site, he is there to support both sites, said MAHC CEO Natalie Bubela. But the lab work required for the procedure is done in Bracebridge and the machinery, a cryostat, is also located in Bracebridge.<\/p>\n<div style=\"float: left; margin-right: 14px;\"><strong><broadstreet-zone zone-id=\"45658\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/div>\n<p>Huntsville hasn\u2019t had a cryostat since 2016, when the equipment broke down and could not be repaired, according to Bubela.<\/p>\n<p>&#8220;It was very old and was unable to be repaired,\u201d she explained. \u201cAs a result, there was a review done by the surgical committee that has representation largely from physicians at both sites\u2026and they actually did an audit for just over six months to look at the amount of times it would be required if it was replaced and they found that there were two cases in that period of time when they did the audit where a cryostat machine would\u2019ve been required.&#8221;<\/p>\n<p>Consequently the committee decided not to replace the roughly $40,000 equipment at the Huntsville site, according to Bubela. &#8220;So the entire surgical committee voted in favour of not replacing the machine and single siting that service, like we\u2019ve single sited other services, to the Bracebridge site,&#8221; she said, emphasizing the fact that the decision was not an administrative one, but one made by the &#8220;clinical people actually utilizing that piece of machinery.&#8221;<\/p>\n<p>In terms of laboratory services, again MAHC\u2019s pathologist who manages laboratory services works out of the Bracebridge site and certain services have been single sited to one hospital or the other. &#8220;At Huntsville we do cytology and microbiology, it\u2019s not done at Bracebridge. At Bracebridge we do histology, which is not done at Huntsville, and then there are core lab services done at both sites,\u201d explained Bubela.<\/p>\n<p>She said the plan is to continue offering plastic surgery at the Huntsville site, but procedures requiring frozen section will be done in Bracebridge.<\/p>\n<blockquote class=\"modern-quote full\"><p>What we were not able to forecast with Dr. Antonyshyn was the type of referrals he was going to get. When they heard a maxillofacial plastic surgeon was available, he received referrals for facial cancers that we had not anticipated. <cite>MAHC CEO Natalie Bubela<\/cite><\/p><\/blockquote>\n<p>&#8220;So because of that, given the area in which an excision is required, it\u2019s his preference and his practise to do a frozen section. So it was only available in Bracebridge, so those times when he needs to do that, we are bringing those cases down to Bracebridge,&#8221; she added.<\/p>\n<p>Esther Millar, Chief Nursing Executive &amp; Clinical Services for MAHC, said the hospital is fortunate to have brought plastic surgery services to Muskoka. &#8220;Through the flexibility of both sites we are supporting the unique needs of these surgical patients for the best possible patient care. Some of Dr. Antonyshyn\u2019s cases at MAHC have been plastic surgery treatment of facial skin cancers, and those procedures can require frozen sections. A frozen section is a laboratory procedure that allows for the rapid analysis of cancerous tissue by the pathologist to aid in detecting if the margins (boundaries) of the removed tissue is clear of cancer. This happens while the surgical patient is still in the Operating Room and helps the surgeon to decide if further resection (removal) of tissue is required to remove all the cancer,&#8221; said Millar.<\/p>\n<p>&#8220;For years now, the histology department of the laboratory with frozen section capability and the pathologist who reviews frozen sections, have been based at SMMH (South Muskoka Memorial Hospital),&#8221; she added. &#8220;The use of the frozen section technique helps to minimize the tissue being removed. Without the frozen section, the surgeon may have opted to take more tissue, which does not put the patient\u2019s best interests first. By having flexibility in surgical services operations across our sites, we can take a patient-centered approach to best support the patient\u2019s needs.&#8221;<\/p>\n<p>Dr. Biagio Iannantuono, a general surgeon at MAHC and the interim Chief of Staff, tried to put it into perspective. In an email to Doppler, he stated: &#8220;It is rare for a surgeon to need and\/or use a cryostat for cancer-related surgery because frozen sections do not work on all body parts. That is because of the different types of tissue in the body that do not lend themselves to this technique. For example, a frozen section does not work for breast cancer-related surgery where a tumour would be removed, nor for breast reconstruction surgery. And to further clarify, not all skin cancers, mainly facial but still very few facial skin cancers, require a frozen section.&#8221;<\/p>\n<p style=\"text-align: center;\"><strong>Don\u2019t miss out on Doppler! Sign up for our free newsletter <a href=\"https:\/\/doppleronline.ca\/huntsville\/dont-miss-out-on-doppler\/\"><u>here<\/u>.<\/a><\/strong><\/p>\n<p style=\"text-align: center;\"><broadstreet-zone zone-id=\"45657\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone>\n","protected":false},"excerpt":{"rendered":"<p>It seems Muskoka Algonquin Health Care\u2019s much lauded and newly implemented plastic surgery program has hit a bit of a snag. That is because Dr. Oleh Antonyshyn, the plastic surgeon [&#8230;]<\/p>\n","protected":false},"author":6,"featured_media":54175,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[10],"tags":[26,205,1849],"class_list":["post-54171","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-breaking","tag-mahc","tag-plastic-surgery"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Plastic surgeries requiring special equipment being moved to Bracebridge hospital site - Huntsville Doppler<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doppleronline.ca\/huntsville\/plastic-surgeries-requiring-special-equipment-being-moved-to-bracebridge-hospital-site\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Plastic surgeries requiring special equipment being moved to Bracebridge hospital site - Huntsville Doppler\" \/>\n<meta property=\"og:description\" content=\"It seems Muskoka Algonquin Health Care\u2019s much lauded and newly implemented plastic surgery program has hit a bit of a snag. 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