medical simulator

Chapter 14 Levels vary
Cai Dongfan's position as chief surgeon remained unchanged, and Du Yanjun's position as first assistant remained unchanged, but Zhou Cheng was obviously moved from the position of secondary assistant to second assistant.

That is, Cai Dongfan's starting side, here, has a better surgical vision.

In fact, Luo Yun doesn't care. He can also perform open reduction of tibial plateau fractures, but the level is not good. If Cai Dongfan didn't perform this operation, he can also do it, but it may take a long time, and the operation The quality is not as good as Cai Dongfan.

In fact, Luo Yun was already familiar with the procedure of the operation, and having followed Cai Dongfan for so many years, he also knew the root of Cai Dongfan's surgical habits.

What he lacks now is the heat. It is not to see how Cai Dongfan performs surgery, but to figure out how to improve the quality of his surgery. This is the key.

Seeing one more operation and one less operation is not much different.

So Luo Yun was just complaining in his heart.

For Zhou Cheng and Du Yanjun, it is very important to watch the complete operation process and operation techniques up close.To personally teach Du Yanjun is also the purpose of Cai Dongfan taking over the operation today.

Whether it was Zhou Cheng or Du Yanjun, no matter what, they were only fighting for a place in the hospital, and there was no competition with Luo Yun.

Even if they are admitted to the hospital, it does not belong to their peers and still does not constitute competition.Luo Yun's attitude was naturally relaxed, and he looked at Du Yanjun and Zhou Cheng.

He found that Zhou Cheng was very calm at the moment, and he was not very excited because he got the second assistant position. Instead, he looked at Du Yanjun with slightly guarded eyes, with helplessness.

Yes, Zhou Cheng's face was full of helplessness, and Du Yanjun's eyes were full of guard, which was fleeting.

Of course Zhou Cheng was helpless, because in fact, from the beginning of this operation, Zhou Cheng felt that he had a sense of control over the operation process from beginning to end, and with perfect skills, he could do better than Cai Dongfan .

Just like the choice of surgical approach, at least Zhou Chengcheng will not choose the combined anteromedial and anterolateral approach, but will choose the LL approach.

During the operation, Zhou Cheng would not stop and stop like Cai Dongfan. This is just a simple V-shaped tibial plateau surgery.

After Zhou Cheng watched the medial open reduction and internal fixation in the first half, he knew that Cai Dongfan's level was probably proficiency, not even proficiency.Even after seeing Cai Dongfan's surgery, he still won't get any improvement.

Instead, it made Du Yanjun wary of him, and Zhou Cheng naturally felt innocent and helpless.

But on the bright side, Zhou Cheng still said: "Thank you Teacher Cai, thank you Teacher Luo."

Cai Dongfan let him take the second assistant position, and Luo Yunrang was grateful for this position.

Cai Dongfan remained silent, and continued to choose the next operation. Cai Dongfan just felt that although Zhou Cheng was only a regular trainee, he was at least a junior doctor brought by him, and he was also a "registered student". too much.

Including the same for Zhang Zhengquan in the future.

This is what I should do as a superior doctor and a teacher. Today, Zhang Zhengquan was dismissed to let Du Yanjun take the stage more, which is indeed a bit unkind.

But there was no way, Du Yanjun was his student, and he wanted to fight for the opportunity to stay in the hospital. As a teacher, he could only help him.If Du Yanjun could stay, it would be a closer relationship than Luo Yun.

A true master-student relationship.

However, the next step is to deal with the lateral platform of the tibia. The lateral bone fracture is not like the medial side where there are too many and strong muscle insertion points, so there is not much muscle traction, and the displacement of the fracture is within a relatively normal range.

Cai Dongfan, as the chief physician, after exposing the broken end of the fracture, used bone peeling to apply a little pressure, and then restored the split fracture to a better position. Because external pressure can be applied, even temporary fixation with Kirschner wires is not enough. No need to fight.

The outer steel plate was also hit directly.

At this time, the reduction and fixation of fracture treatment principles have been completed, but this is not over yet.

The entire operating room must have a surgical process and rigorous thinking.

Next, it is natural to return to the tibial plateau classification itself.

Tibial plateau fracture, type V of Schatzker classification: bicondylar fracture involving medial and lateral plateau splitting, combined with vascular and nerve injury, this type accounts for 12.0% of tibial plateau fractures!

This is a classification in the strict sense, and the definition is written like this, but in fact, whether the blood vessels and nerves have really been damaged has to be explored during surgery.

The nerve that is most likely to be injured is the common peroneal nerve. The fibula is on the outside of the tibia, so the place that needs to be explored is the outside of the tibial plateau, the common peroneal nerve and blood vessels near the head of the fibula.

This is the basic operation!

Common fractures are caused by violent trauma, and the exploration of tendons, nerves, and blood vessels during surgery is part of the basic operation.If it is an open fracture, it is even more necessary to explore.

In the simulator, Zhou Cheng once failed to master the exploration technique systematically, resulting in undiscovered damage to blood vessels, non-union of fracture ends after surgery, and avascular necrosis of bone.

To Cai Dongfan, this kind of operation was nothing more than an extremely simple matter.

The Chief Physician is rated, if he can't even do a good job, then the Chief Physician is too good.

The operation ended without any disturbance, and Zhou Cheng did not have too many outstanding performances after the treatment on the inner platform, and Cai Dongfan and Luo Yun did not deliberately require Zhou Cheng to have an outstanding performance.

After the operative surgery is over, however, there is one more step.

That is stitching.

While taking off his clothes, Cai Dongfan said, "Luo Yun, don't step down yet. Later, Zhou Cheng and Du Yanjun will sew up the wound on one side. Watch it."

"After internal fixation of this kind of tibial plateau fracture, because of the intervention of the steel plate, the suture should be more rigorous."

After finishing speaking, Cai Dongfan took off his clothes completely, then picked up the mobile phone on the storage table, stepped on the sensor door of the operating room with his foot, and went outside, probably to the lounge or smoking room of the operating room .

This is Cai Dongfan's right as the chief physician and the top doctor leading the team.

For the rest, Luo Yun looked at Zhou Cheng and Du Yanjun's two pups, and said, "Du Yanjun, you sew the inside, Zhou Cheng, you sew the outside."

"Tour, prescribe two 2-0 and 1-0 antimicrobial microjoe."

Antimicrobial Micro Joe is a common name for a stitch with a needle.

2-0 and 1-0 are the diameter of the suture, also called the model number.The inner part of the skin needs to be stronger, so 1-0 sutures are used to suture the subcutaneous tissue, and the surface of the skin requires smaller scars, so 2-0 sutures are used.

Because the steel plate is added, the tension of the skin is relatively high, and the sutures below 3-0 are easy to break and rupture the wound after the operation.Of course, if the subcutaneous suture is good, you can also choose cosmetic suture.

But the beauty line of cosmetic sutures is not cheap.And it's not covered by health insurance.

Except for children and girls who love beauty, basically they will not deliberately ask patients if they need cosmetic sutures, unless the patients themselves ask for it.

Soon, the circulating nurse brought the sutures to the table.

For skin suturing, one 2-0 suture on one side is definitely enough, but for subcutaneous suturing, the periosteum, muscle layer and subcutaneous layer are sutured, and it is estimated that one suture is not enough.

Zhou Cheng and Du Yanjun each held a pair of tweezers and a needle, and waited for the stitches to come.

Du Yanjun looked at Zhou Cheng with a smile on his mouth, but his eyes were fixed.The reason why I dare to laugh is because there is a mask that blocks it, and the reason why my eyes are not clear is because I don't want to be too obvious.

For surgeons, suture is the foundation of the foundation, and the level of suture also has a level.Although Zhou Cheng came to the department earlier than himself, but with one more year of experience, the level of suturing may not necessarily be better than his own.

PS: Ask for collection, ask for recommendation tickets, ask for follow-up reading, ask for monthly tickets.

(End of this chapter)