godfather of surgery

Chapter 10 Doubt

I don't know what time it is in the middle of the night.

In the duty room, there was a knock on the door.

"Who is it, why don't you let people sleep?" Zhang Lin opened the door and roared, sleepy and wanting to beat people.

There is a switch at the nurse's station. When you press it, the doctor's duty room will ring, and you can broadcast a conversation.Zhang Lin thought the trainee nurse didn't understand, so he ran and knocked on the door.

"Director Tian?"

Zhang Lin was super embarrassed.

Director Tian was putting his white coat on his body, his face was angry, no, it was murderous: "Did you have the surgery?"

Zhang Lin rubbed his sleepy eyes: 'Yes! '

"You guys are courageous enough, you are too irresponsible, is there such a thing?" If it wasn't for years of higher education, Director Tian would be scolding mother now, and even if he didn't wait for him, he should have waited for Lao Jin to come to power.

Zhang Lin was frightened. When he was in the dressing room after the operation, he wanted to call Director Tian to report, but the phone was out of power, and he was afraid that it would automatically shut down. He wanted to go back to the ward to recharge and call again. .

After this fierce criticism, I remembered: Director Tian should have performed the operation because the traffic jam was on the road.

But what time is it, he came over after the surgery, and knocked on the door angrily. Zhang Lin was dissatisfied, but he couldn't show it on his face.

After all, it is common practice for lower-level doctors to be scolded by higher-level doctors.

After being scolded by Director Tian, ​​Zhang Lin immediately woke up and pulled up Yang Ping, who was still sleeping.

Director Tian put on a white coat and rushed to see the blood supply of the patient's severed finger. Zhang Lin and Yang Ping followed behind, not saying a word or daring to fart.

In order to refresh his mind, Zhang Lin quickly took out a box of balsamic essence and rubbed it on his temples.

The two figures, like elementary school students who made mistakes, followed behind the dean.

It turned out that as soon as Director Tian arrived at the hospital, he went straight to the operating room and asked the nurse, saying that the operation was over and the patient had been back for an hour.

Back to the department, the nurse said that Yang Ping and Zhang Lin were sleeping.

He calculated with his fingers, it had been more than two hours since he received the call, and the patient had been back for an hour, that is, the operation time was more than an hour.

One hour, based on the level of these two bastards, wouldn't they just do a larger debridement and suture? Could it be that the two bastards, regardless of 21, [-], seeing that he has not arrived, can't wait, even blood vessels and nerves? No connection, Kirschner wire to fix the fracture of the broken finger, and directly sew the epithelium?

Is it so absurd?If so, it would be a fake surgery.

Pastoral's footsteps are getting faster and faster, the more he thinks, the more angry he is, and the blood rushes to the top of his head.

I don't care about disturbing the patient's rest. It is still a few hours after the injury. If there is still hope for the operation table again, it will be too long to wait until tomorrow morning, and the fingers will be necrotic. No matter how to remedy it.

Director Tian's brain patched the patient's severed finger: pale, shriveled, icy cold, with no blood supply!
With a snap, the sound of a switch, the lights in the ward turned on.

Analgesia was done well, and the patient was asleep.

When the light was suddenly turned on, the strong light stimulated, and when the doctor "killed" to the bedside, the patient and his companion immediately woke up, squinting to avoid the stimulation of the strong light, not knowing what was going on.

"Round rounds, look at the blood supply of your fingers!" Zhang Lin stood tremblingly beside the bed, explained to the patient, and then turned on the small flashlight he carried with him.

Tian Yuan squeezed Zhang Lin away, grabbed the flashlight, and shone the beam on the patient's injured thumb.

The end of the severed finger was exposed, full and rosy, and the pastoral touch gently reached out, it was warm!Then gently squeeze again, the finger pulp is full and elastic, and the capillary reflux test of the nail is normal.

How is this possible? It's unreasonable.

"Syringe needle!"

At this time, the nurse had already pushed in the dressing cart, which contained dressing kits, cotton swabs, Aner's iodine disinfectant, syringes, and so on.

The nurse handed over two cotton swabs dipped in Aner's iodine, and Tian Yuan eliminated the poison twice. Tian Yuan handed over the syringe with a needle. Tian Yuan cautiously stabbed three needles at different positions on the pulp of the finger, just under the skin.

Bright red blood came out slowly, at first a little, then slowly expanded, and finally flowed to one side.Tian Yuan turned to look at Yang Ping, then Zhang Lin.

"The blood supply is very good! Sorry to bother you, we have to check the blood supply every hour." Tian Yuan explained to the patient.

The patients and their family members felt a little frightened, and said hurriedly: 'It's okay, it's okay, hard working doctor. "

Everyone went back to the doctor's office, all sat down, and the atmosphere was relatively tense.

The pastoral thoughts were blocked, what happened, did they really anastomos the blood vessels?Impossible, it's only an hour, and after the three-quarter break, I have to do it for two or three hours, and I need to be in good condition with the station.It's impossible for these two boys in an hour.Don't know where is the problem?Or the time is wrong.

"What time does the patient arrive at the emergency department? What time does he enter the operating room? What time does the operation start? What time does the operation end?" A series of questions from Tian Yuan.

"I arrived at the emergency department around 10:30, I arrived at the operating room at 11:30 to start debridement, and at [-]:[-] I officially started kissing blood vessels, and the operation ended at about [-] o'clock." Zhang Lin remembers it very clearly, although I can't remember the exact time. Clear, but remember about the time.

The nurse was also stunned by Tian Yuan's face, thinking that something major happened, the nurse was more flexible, and immediately brought the medical record folder, Tian Yuan took the medical record folder.

"It's okay, you go do your work, we'll sit here for a while." Tian Yuan said to the nurse gently.

He carefully opened the medical record, found the anesthesia sheet and the surgical nursing record sheet, and carefully looked at the time with his fingers. There was not much difference between the time and what Zhang Lin said.

The actual operation only takes half an hour, who is it to coax?
"Really anastomotic blood vessels?" Tian Yuan asked.

"Two arteries, four veins! Two fractures, each of which is anastomosed like this." Yang Ping said seriously.

Tian Yuan helped his glasses: "At present, the blood supply is good, but the operation only lasted more than half an hour. Why is it so fast? Is it a complete disconnection?"

Only then did Tian Yuan realize that it may not be a real severed finger at all, and there are tissue connections. The blood vessels on one side are good. No matter whether the blood vessels are sutured or not, the survival will not be affected. Breaking is two different things.

But—but—Zhang Linfa’s pictures I’ve seen, they’re clearly broken, and they’re still three verses.

"Complete disconnection, two disconnected planes!" Zhang Lin's tense nerves loosened, he turned on the phone, and called up the picture. He realized later that Tian Yuan suspected that he and Yang Ping did not have blood vessels anastomosed, and just did simple sutures.In this case, there is no need to be nervous. I watched the entire operation process, not only the blood vessels were anastomosed, but the quality was also very good.

This is easy to handle, let Director Tian watch the video, tell me earlier, I almost got a myocardial infarction.

"Director Tian, ​​a video was recorded during the operation, why don't you take a look at the video."

Zhang Lin immediately said that when he was nervous just now, his head was muddy.

Look at the video, this is a way, Pastoral nodded.

Zhang Lin copied the video and stored it on the computer he used in the office. Everyone gathered around the computer and Zhang Lin transferred the video just now.As the video played, Tian Yuan turned his head to look at Yang Ping suspiciously from time to time - in this video, is this kid operating.

The equipment does not vibrate under the microscope, and the movements are extremely skilled, smooth, steady and brisk, without any redundant movements, and every movement is done at one time.The quality of the anastomosis of blood vessels, nerves or tendons is not generally good. Even if you have talent, there are not hundreds of thousands of operations that cannot achieve this foundation, and even the final skin suture is perfect.

The operation under the microscope requires special training and a certain talent. The balance of the hands should be good, and the shaking should not be carried out. Because a little shaking will be magnified under the microscope, which will seriously affect the operation.

Vascular anastomosis requires extremely high requirements. The tissue outside the broken end of the blood vessel, including the adventitia, must be cleaned up. Otherwise, a little bit will be brought into the blood vessel lumen during anastomosis, which will cause thrombosis and block the blood vessel.The blood vessels should be aligned accurately and there should be no misalignment. Otherwise, the blood vessels will be narrowed or not smooth, resulting in abnormal blood flow, slowing down the flow rate or forming eddy currents, and it is easy to cause blood clots and block the blood vessels.

Therefore, the anastomosis of small blood vessels requires the highest suture technique in surgical operations.

A surgeon has to practice under the microscope to match countless mouse tails or rabbit ears to achieve this superb match.Like Director Han, Director Tian, ​​and Song Zimo all came here.

After watching the video, Tian Yuan turned the video upside down and read the key steps repeatedly, for fear of missing the details.

"You can rest, it's hard work, the quality of vascular anastomosis is quite high, but don't be careless, tell the nurse to pay attention to observe the blood supply, and deal with any problems at any time." After watching the video, Tian Yuan felt instantly at ease, as long as the quality of the operation is good, the patient's health can be guaranteed. Medical safety, no problem.

Tian Yuan wanted to say something, but didn't know what to say.

"Go and rest, I'll go to the operating room, Lao Jin and the others haven't finished it yet."

(End of this chapter)