medical simulator

Chapter 180 Difficult Choice! (seeking subscription)
After Cai Dongfan and Luo Yun arrived at the lounge, they immediately lit a cigarette and stuffed betel nuts.

The irritating betel nut immediately gave rise to a nauseous feeling of hiccups, which made people very uncomfortable, but the pain in the mouth and the choking sensation in the throat also made Cai Dongfan and Luo Yun instantly sober.

The eyes of both of them were quite dull, not because they were desperate for life, but because they were really tired.

However, not long after Luo Yun sat down, the phone on the table vibrated. When he picked it up, he saw that it was the landline number of the hospital.

"Hey!~"

"Is this Dr. Luo Yun from the Department of Orthopedics? I'm the guide of the outpatient clinic. It's already past 40:[-], Dr. Luo, why don't you come to the outpatient clinic? The patients here are starting to quarrel." The other end of the phone , There was an urging female voice in a low voice.

Luo Yun frowned tightly at that time: "Didn't I call the head of the hospital yesterday to cancel my outpatient clinic today?"

"I don't know, it hasn't been cancelled, and we haven't received a notification. Now the outpatients have arrived at the door of the clinic. There are more than 20. I just say that Dr. Luo is doing ward rounds. You have to wait for a while, but it's too late." It's nine o'clock."

"I can't hold on anymore." The opposite party was complaining to Luo Yun, hoping that he would hurry over.

Today is Sunday, and it is Luo Yun's second outpatient visit.

Luo Yun felt his balls hurting.

He knew about today's outpatient clinic, but something special happened yesterday, so he called to cancel the outpatient clinic, but it hasn't been arranged yet. Now, the operating room has been rolled out.

The outpatients have already arrived, isn't this bullshit?
"Don't the patients who came to see the doctor know what happened yesterday?" Zhou Cheng asked again in a low voice.

"I know, but they said that they have to see a doctor after registering. What happened yesterday is the hospital's problem. Can't it be arranged for such a big hospital?"

"Doctor Luo, what do you think now?" The outpatient guide was cautious and did not dare to threaten Luo Yun directly.

But if Luo Yun hadn't gone, then they wouldn't have been procrastinating, and it wasn't their fault.

"Oh!~~~"

Cai Dongfan's eyelids were twitching. After taking a deep breath, he said, "Go to the outpatient clinic. Luo Yun!"

"Then this operating room? What's going on?" Luo Yun looked at Cai Dongfan in embarrassment.

Although this is not his Luo Yun's problem, it happened suddenly, but today, three operating rooms were arranged for his team for the first emergency operation. If he lacks a chief surgeon, the operating room will be taken back Not to mention, I don't know how long it will be delayed after today's operation is over.

And when the emergency rescue was carried out in the whole department yesterday, someone from his own team did not show up, that is, Zhou Cheng who went to the on-site emergency team. Yan Hanhan had a lot to say, although he didn't say it face to face.

If Luo Yun still slipped away today, I don't know what Yan Haihan will say again.

"The outpatient number has been released, I'll think of a way!" Cai Dongfan's small eyes kept rolling, obviously thinking about what to do.

There are still too many patients and too few doctors!
Moreover, Luo Yun had already said in advance that he would cancel the outpatient clinic. Either the medical department was not strong enough, or the outpatient office was cheating and playing tricks. What can we do?
Can you go to the outpatient clinic or quarrel with the medical department?

Doctors also have the sophistication they should have, not sophistication, but sophistication will find you unconsciously.

Luo Yun had no choice but to put out the cigarette butt, and then hurried to the outpatient clinic.

After registering, there is no official notice from the hospital and the registered patient communicates with the registered patient about changing the number or refunding the money, then a diagnosis and treatment relationship is established, and each report is accurate.

At that time, the outpatient department and the medical department will not give you any other reasons. You have to watch it after you release the number.

However, in order to save time, Luo Yun called the outpatient department as soon as possible, asking them to suspend their account, and also asked them to notify the registered patients that they had better come to the consultation room in the morning.

This is the only solution Luo Yun can think of.

Not long after Luo Yun walked out, Cai Dongfan vomited betel nut dregs, then extinguished the cigarette butt, and re-entered the operating room where Zhou Cheng was.

When he entered the operating room, he saw Zhou Cheng alone, and asked, "Xiao Zhou, where is Du Yanjun? Has he slipped away?"

He thought that Du Yanjun ran back secretly to be lazy.

The tone and mood are a bit off.

Zhou Chengdao: "I'll let Yan Jun go down to rest for a while, and then go back to the operating room after the patient comes in. I guess he's only in the waiting room. Mr. Cai, are you looking for Yan Jun?"

Cai Dongfan's preparation before was that Du Yanjun followed Zhou Cheng, he took him to the beach, and then Luo Yun took Zhang Zhengquan.

But now that Luo Yun went to the outpatient clinic, the operation arrangement had to be readjusted.

"Well, he can't go to rest! Luo Yun has to go to the outpatient clinic, and he has to go to the 19th room to be the surgeon. At that time, I will ask Zhang Zhengquan to come to your place to help."

"Damn. What's going on every day." Cai Dongfan walked out of the operating room cursing, and took out his mobile phone, and called Du Yanjun.

Du Yanjun just lay down, and when he heard this, he quickly stood up again, dragged his tired body, and fought vigorously again.

Moreover, because there was no one to help, he had no choice but to go to the Seventeenth Room first, and then called Zhou Cheng to the Nineteenth Room to help lift his legs, disinfect and spread the towels.

In the absence of people, one person can only serve a few people.

After doing all this, Du Yanjun had time to look at the patient.

This is an open injury of the knee joint with exposed blood vessels, which belongs to that kind of rather complicated debridement operation!

Du Yanjun's scalp was throbbing, looking at the patient, he was at a loss.

However, both the anesthetist and the itinerant nurse looked at him.

There is no hand-washing nurse in this operation. Yesterday’s hand-washing nurses were all tired and went back to rest. Most of the shifts today are patrolling!

Although I can wash my hands, when I am on stage, there is no one to take things and help off stage.

Zhou Cheng walked out the door, saw that the operating room in the seventeenth room was still empty, then turned his head again, and gave instructions to the tour operator in the nineteenth room: "After the patients in the seventeenth room are anesthetized, call me to come on stage."

"I'll take the stage here first."

Debridement and suture are also very particular. Strictly speaking, simple debridement and complex debridement should not belong to the same level of surgery, but when the surgery is graded, they are all divided into debridement and suture. It's just surgery.

Zhou Cheng knew that such a third-degree open knee injury was not something Du Yanjun could handle.

This kind of open injury of the knee joint is a small case at the emergency scene, because the task of the emergency scene is to transfer the patient to the hospital and save his life.

When it comes to the emergency department, it is just quite tricky. The purpose of the emergency doctor is to bandage, stop the bleeding, and then transfer to a specialist.

After entering a specialist, the real treatment actually begins!
It is the most basic principle to save lives first and then treat diseases.

However, saving lives is obviously not the ultimate goal of medicine, it is only the most basic goal.

It's like an open trauma to a joint.

Open bones and joints can be divided into three degrees according to the severity of the injury:
First degree: The skin is punctured from the fracture end from the inside to the outside. The soft tissue injury is mild or the joint capsule is punctured by a sharp instrument. The wound is small, and the articular cartilage and bone road are not damaged.

The second degree: the skin is cut or crushed. The subcutaneous tissue and muscle tissue are moderately damaged or the soft tissue around the joint is extensively damaged, the articular cartilage and bone are partially destroyed, and there are foreign bodies in the wound.

Third degree: Extensive and severe damage to the skin, subcutaneous tissue, and muscles, or soft tissue damage around the joints, rupture of ligaments, severe damage to articular cartilage and bones, foreign bodies in the wound, combined with blood vessel, nerve damage, or joint dislocation.

If it is a first-degree injury, it can be treated as septic arthritis, even without excessive debridement.

Du Yanjun gritted his teeth, he could try debridement of the second degree open joint injury, but the debridement and suture of the third degree joint injury requires not only the removal of necrotic tissue, but also the reconstruction of muscles and ligaments.

There may even be an anastomosis of blood vessels and nerves. Such debridement is not easy.

And this kind of patients, in the first aid scene, in the open trauma, are relatively mild!
Hearing Zhou Cheng's words, Du Yanjun felt as if he had received an amnesty, as if he had met a savior. Just now, when Cai Dongfan asked him to take the stage, he was a little happy. surgery.

But after entering the operating room and seeing the patient's condition, I immediately felt at a loss.

Zhou Cheng washes hands, dresses, and wears gloves!

"Teacher Tour, put on the tourniquet, the pressure of the tourniquet should not be too high!" Zhou Cheng ordered.

Open joint injury, accompanied by vascular injury, if the pressure of the tourniquet is too high, the open vascular injury may not be found, making the debridement operation incomplete, or the vascular injury that should have been discovered may not be found.

This is bullshit.

"Open another lower extremity fracture package." Zhou Cheng gave another order after glancing at it for a while.

The instruments in the lower extremity debridement pack and the fracture pack are different. Although there are some duplicates inside, if there are some instruments in the fracture pack, the operation can be carried out more smoothly!
"Yan Jun, let's investigate together, you look for foreign objects, I'll look for blood vessels!"

For destructive injuries, the blood supply must be found first, which is the first prerequisite for judging whether the limb can be saved.

If the blood vessel damage is serious, don't even think about it, either blood vessel transplantation or amputation!
For simple things, he handed them over to Du Yanjun, so there must be no problem.

If it was complicated and Du Yanjun couldn't handle it, Zhou Chengcheng picked it up by himself.

Otherwise, if you always procrastinate, you will waste a lot of time loving you.

"Okay! Brother Zhou Cheng." Zhou Cheng came to the side, so decisive and straightforward, which gave Du Yanjun the backbone!
There was even a feeling of tears welling up in his eyes. Just now, he was scurrying around like an ant without a leader, but he quickly organized his thoughts——

He immediately used a suction device to suck up the blood clots on the surface one by one, and then used the thyroid retractor to slowly pull the inner layer.

During the on-site first aid, although most of the sundries or foreign objects will be cleaned up, it is impossible to clean them up after all. It is necessary to carefully explore during the operation to ensure that there is no residue.

And while Du Yanjun was looking for foreign objects, Zhou Cheng's side had already begun to judge the anatomy out of shape quickly.

The arteries at the knee joint take shape, mostly focusing near the popliteal fossa.

Fortunately, it is the patient's open joint, which is in front.So the popliteal fossa may be protected and not involved, but the blood vessels below the popliteal fossa, that is, below the tibial plateau, need to be carefully explored.

Moreover, it is necessary to straighten out the shape of the muscles at the starting and ending points of the tibial plateau, identify the tendons and muscles one by one, and then rebuild the bone defect and muscle insertion points...

The treatment of simple bone defects is very simple, and Zhou Cheng can also do a good job of simple tendon insertion reconstruction.

But when the two exist at the same time, then the difficulty is not as simple as one plus one, or even a simple exponential increase!
Instead, it directly increased the difficulty to several or even hundreds of times!
Do you want to rebuild the bone, do you want to rebuild the tendon, and how?

Can muscle grow without rebuilding bone?What to do if the muscles atrophy without rebuilding the tendons?
What if the tendon is rebuilt and the rebuilt bone is strained?
The reason why surgery is complicated, or the reason why some diseases are complicated, is that there is no very logical one-to-one correspondence.

It is not even possible to find a perfect counterpart that is very perfect and fit.

However, this issue should be considered later.

While Du Yanjun was sorting out stones, broken gravel, glass fragments and blood clots, he also sneaked a look at Zhou Cheng, and found that Zhou Cheng had exposed the corresponding blood vessels and nerves at some point. out!

The nerves were contained by Zhou Cheng with the cut off rubber gloves, and the blood vessels were fixed by him with silk threads.

Moreover, Zhou Cheng's fixation was not the kind of fixation that was tied off, but a dead knot.

The dead knot is above the blood vessel, and the blood vessel has not been punctured, but the blood vessel can be pulled out.At the same time, he also classified the broken muscles and clamped the tendons with vascular forceps.

Vascular forceps cannot clamp the muscle, because it will dissolve the muscle tissue and cause death similar to rhabdomyolysis.But the tendon can be clamped, there are no blood vessels in the tendon, and the clamp will not dissolve!

However, after Zhou Cheng finished these, the [-]th and [-]th tours came to remind him.

Said: "The anesthesia in Shiqijian has been administered, and Dr. Zhang over there has been sterilized. I asked Dr. Zhou if you want to go there?"

"I'll be right over!" Seeing this, Zhou Cheng stepped off the stage immediately!

While unfastening the gloves, untie the clothes at the same time!

"Brother Zhou Cheng, what?" Du Yanjun panicked when he heard that Zhou Cheng was about to step down.

If this operation is completely entrusted to him, he will not be able to take it.

Now it is no longer a matter of mobile phone opportunities, but the situation encountered is beyond the scope of ability, and Du Yanjun can't handle it.

Although he really didn't want to admit that he was much worse than Zhou Cheng, in fact, he had already recognized the fact that Zhou Cheng was the junior superior in the group.When Zhou Cheng was here, he felt very at ease, as long as he did things well.

Everything can be handed over to Zhou Cheng. Before Zhou Cheng took the stage, he panicked a lot!
Now that Zhou Cheng was about to leave, he was still in a panic.

When there are many opportunities, if you can't grasp them, this is a sense of powerlessness!

"Debride the wound first, don't worry!" Zhou Cheng comforted Du Yanjun calmly.

Zhou Cheng must step down.

Seventeen is his main battlefield, this is one of the reasons!

The second is that he has already investigated the patient clearly, so Du Yanjun can slowly remove the foreign body, and then clean up the necrotic tissue.At least in this way, the patient's life will not be in danger!
But next door, he hasn't seen what's going on, he still has to take a look first, so he can know for sure!

If this kind of third-degree open knee injury is a small debridement, then the situation next door will definitely not be too small. If Zhang Zhengquan is alone there, if something happens, it will be troublesome up.

Still not enough staff.

Teacher Luo.

"Yan Jun, don't throw away these bone fragments. Put them in a dish later and soak them in complex iodine. I'll go over and see the situation," Zhou Cheng ordered.

Luo Yun had no choice but to go to the outpatient clinic, but when he left, the patient still had to be taken care of, and there was no way he could run around!
He only hoped that the 21 rooms at Cai Dongfan's side could be completed sooner, and then an operating room would be taken over in the gap.

Otherwise, Zhou Cheng really felt a little unfocused if he ran on both sides.

You have to be specific in surgery.

"Okay, Brother Zhou Cheng." Du Yanjun was a little panicked when he saw Zhou Cheng leave, and also a little afraid that the patient would suddenly disappear after Zhou Cheng left.

However, after Zhou Cheng has sorted out the muscles, blood vessels and nerves, the operation is actually not that difficult, and he can start to walk step by step.

Zhou Cheng went out, washed his hands, and entered the Seventeenth Room.

While putting on his clothes, he directly asked, "Quanzi, what's the condition of this patient?"

"Arterial embolism, plantar injury, lower leg amputation!" Zhang Zhengquan hurriedly replied, he also knew the patient's situation clearly in advance!

Zhang Zhengquan knew.

Luo Yun left suddenly, and Du Yanjun next door couldn't bear it alone. Before that, Zhou Cheng was helping next door. He wasn't in the hospital yesterday, and he didn't make rounds in the morning. He definitely didn't have time to understand so many things.

"How long has it been tied?" Zhou Cheng asked again.

"Are you wearing a tourniquet?"

Zhou Cheng looked at the patient's foot and removed the bloody damaged sole. It should be a girl's foot, and she should not be very old.

Then, as he walked towards the operating table, he looked around quickly, his mind racing wildly.

If the embolism time is not long, this amputation can still be salvaged!
Amputation is the last step in orthopedics, and he doesn't want patients to go to this step unless it happens.

"The tourniquet is on." Zhang Zhengquan hurriedly replied.

"I don't know how long it's been tied."

"Little sister, do you know when you were admitted to the hospital?"

"Boom!~"

"Bah!~" Lying on the operating table was a young girl who was under spinal anesthesia at the moment, sobbing while sucking her nose.

"Boom!~"

"呲!~"

The sound of air hitting the nasal cavity and the sound of snot piercing through the nose sounded one after another, and so on.

"Little girl?" Zhang Zhengquan asked again.

"I was admitted to the hospital after four o'clock. Doctor!"

"呲呲呲!"

"Woo! Uuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuuu" As she spoke, her body trembled slightly.

Both lower limbs were anesthetized, but the abdomen was still trembling slightly!

Heart of beauty in everyone!

Let alone a little girl, she has always been looking forward to growing up, wearing nice clothes and high heels...

Amputation, this is something she has never considered, but when she arrived at the hospital, the doctor said that amputation is the only way to save her life, and she couldn't do anything about it.

Her parents had already quarreled with the doctor a lot, to no avail.

There was even mention of transferring to the Affiliated Hospital of Shonan University and the Second Hospital, but to no avail.

No beds.

Now, the doctor asked again, and she could only answer like this.

Zhou Cheng looked at the time on the timing panel, and it was already 41:[-].If it is calculated according to the time of embolism, it should only have been embolized for more than four hours.

Zhou Cheng looked at the wound again, active bleeding was looming, although it was not much, but it also confirmed from the side that the little girl may not have had a serious embolism.

This may not necessarily meet the indications for amputation? !
"Does it have to be amputated?" Zhou Cheng didn't dare to talk nonsense, and stepped forward to lower his voice with Zhang Zhengquan.

However, when Zhou Cheng asked this question, Zhang Zhengquan thought of what Zhou Cheng wanted to do, and hurriedly left the operating table for a certain distance, feeling that the distance was almost enough.

He approached Zhou Cheng and said in a very low voice: "Brother Zhou Cheng, she still has to jump in the queue for this amputation operation! This is also considering that she is relatively young."

"There are still several emergency departments in the back! If you want to do limb salvage surgery, there will be too little time, right?"

Zhang Zhengquan did not say that Zhou Cheng would not be safe, but just told Zhou Cheng the fact!
Ok?
What's the meaning.

Zhou Cheng's expression froze, and he looked at Zhang Zhengquan.

Is there a time limit for surgery?

Zhang Zhengquan saw the suspicious look on Zhou Cheng's face again: "Well, Director Cai and Teacher Luo have already discussed it during the rounds."

"Her operation was inserted temporarily. The operation time is only half an hour!"

"Otherwise, the subsequent emergency surgery arrangement will not win! If it is delayed for too long, the life of the subsequent surgery patients may be in danger.~"

"Now everyone in the department is working exhausted, it is impossible to save this time." Zhang Zhengquan still whispered.

Limb Salvage and Amputation!
Although the difference is only one word, the difference is actually huge.

The cost of time spent is completely different.

After Zhou Cheng heard it, he felt a little irritable!
This shit? !
In this situation, if it is in a normal emergency situation, he feels that if he works a little harder, he can keep his leg!

but?

In the case of a major emergency, should it be so cruel?
This little girl is young, according to the principle of giving priority to the elderly and children, she jumped in the queue for surgery, but the time of the surgery cannot be delayed!Otherwise, it is unfair to the patients behind.

The operation time was limited, and her hope of limb salvage was completely wiped out!

Originally there was hope of limb salvage, but amputation was necessary because of lack of time.

There are a lot of emergency patients now, if too much time is spent on her, the patients behind may die!

And this is the case when all the people in the two departments of orthopedics are dispatched by the whole army, and it is not said who is being lazy!
"I'll think about it again, wait a moment." Zhou Cheng forced himself to calm down.

This choice is not easy to make. If it is an elective operation, then you can take it slowly, as long as you give the best treatment to the patients you meet.

But this little girl was cut in line for surgery, if she spends too much time on her body, what about the patients behind?
What if someone dies? !
That's death for wasting time!
This is a firm and cruel choice.

It must be done, and it must be done as soon as possible.

"Can't the emergency patients be transferred?" Zhou Cheng asked Zhang Zhengquan, but Zhang Zhengquan looked confused.

"All of them are overloaded. If they can be transferred out, Teacher Cai pushed them away yesterday."

"Also, last night." Zhang Zhengquan suddenly stopped in the middle of speaking.

"Brother Zhou Cheng, amputate! Don't even think about it."

"Last night, a relative of Director Yan died because he didn't have time for surgery."

"At that time, he scolded Director Cai! He said that he got you out at this time, no one!" Zhang Zhengquan said in a low voice.

"Director Yan also blew up in the department this morning."

Zhou Cheng felt a little wronged, he went to TM to participate in the on-site first aid, I didn't go to play!
Can this be my fault?
However, Zhou Cheng thought about it carefully, and it seemed that there was nothing wrong with Director Yan blaming him.

No matter what, Zhou Cheng still occupied the quota in the department. If Zhou Cheng was not in the department, another person would come, at least one more person to help!

With one more person, all possibilities will change.

However, Zhou Cheng was left on the scene, which caused Director Yan's relative to be operated on too late and died!

Even if you, Zhou Cheng, have a huge mission outside, he is still absent from the orthopedics department of No. [-] Hospital.

Although it has been reported to the hospital, everyone else in the eighth hospital has come back, so why don't you come back?

Just you special?

Zhou Cheng asked: "Director Yan didn't let you jump in the queue?"

"No. Director Yan was on the stage at the time, and he thought that Director Cai could have three people performing surgery, but you also know that the situation like yesterday was really true."

"If we can't arrange manpower, we will go into shock soon." Zhang Zhengquan said.

Zhou Cheng took a deep breath, suppressed the fluctuation in his heart, and said, "Then let's do it, amputation!"

When he said this, Zhou Cheng's eyes were a little red.

Very reluctant!

Because of this surgery, even if the amputation is done flawlessly, it is a regret, and it is a regret that cannot be changed once it happens.

But no way!

Zhou Cheng has no right to affect the right to life of subsequent patients because of his selfishness.

There are gains and losses, sometimes, life is full of all kinds of regrets, and the regrets in front of you are nothing compared to life!
"Good~!" Zhang Zhengquan immediately started to move.

Then Zhou Cheng changed his clothes and was about to go on stage.

Zhou Cheng's mastery of anatomy has reached an unimaginable level.

Because it was an amputation of the middle and lower part of the calf, Zhou Cheng made an incision in the middle and lower part first.

Then, he quickly found the course of the artery and vein, and then tied it firmly!

Puncturing the arteriovenous means that there will be no hemorrhage, and it doesn't matter if Zhang Zhengquan uses a chainsaw to play with the chainsaw.

Moreover, Zhou Cheng also made the skin incision for Zhang Zhengquan.

Finally, he looked at the little girl's leg reluctantly.I said sorry in my heart!

Then he turned his head and said, "Quanzi, in a moment, you can directly amputate from the far end of the artery and vein where I tied it, as long as the artery and vein are cut off!"

"For the osteotomy of the tibia, put more in. For the rest, you should have followed the stage many times, it doesn't matter."

"I went next door and there was debridement for an open knee injury."

Zhou Cheng was about to go out. The amputation here was not too difficult. Zhang Zhengquan could practice his hands and familiarize himself with anatomy.

As for the third-degree open injury of the knee joint next door, it is obvious that people need to deal with it in time.

Half an hour was enough for Zhang Zhengquan to amputate.

Although she came to jump the queue because she was younger and the operation time was short.

She couldn't delay the surgery.

but?

"Wait a minute!" Zhou Cheng suddenly thought of something, and then he raised his hand when he walked into the operating room.

After interrupting Zhang Zhengquan, he turned to look at him.

"You mean in this operating room, her operation is to jump in line for amputation, right?"

"The debridement of the third-degree knee injury next door should not be limited in time, right?"

"Then if the next surgery can be done next door, can the time difference be avoided?" Zhou Cheng asked Zhang Zhengquan.

He didn't participate in the operation arrangement, so he didn't know how to pick up the patients later.

"For the debridement of the knee joint, the time given by Director Cai is more than two hours. It may be a little more. Brother Zhou Cheng?"

"You mean, the next patient will go to the next one?"

"But the knee joint debridement, half an hour?" Zhang Zhengquan's eyes widened.

"Enough! Half an hour is enough." Zhou Cheng said.

Then took a deep breath.

"If you try hard, the last time it will be amputation."

After Zhou Cheng finished speaking, he was about to leave, but Zhang Zhengquan ran up to catch up with Zhou Cheng, and said, "Brother Zhou Cheng, you can't shorten the operation time of other patients for the sake of other patients, and you must ensure the quality of the operation."

"I know."

Zhou Cheng nodded: "Quanzi, I'll go to the next door right away to help Du Yanjun debride the wound, and the operation will be completed in half an hour."

"On your side, debride the wound first, and do as much as you can. Give me half an hour, and I'll come over and try limb salvage, and then go to the next operating room for the next operation!" Zhou Cheng suddenly found a chance.

Three surgeries were performed consecutively, with a time difference.

Then this can maximize the benefits.

Hearing this, Zhang Zhengquan immediately became anxious: "Brother Zhou Cheng, this is not very good, is it?"

"In principle, an open third-degree injury of the knee joint is not a primary suture. There is nothing wrong with it."

He does not have the ability and right to decide the life and death of other people, but if he can save time, reduce the turnaround time, and save the time of this limb salvage operation, he can fight for it!
Surgery is prioritized, and some diseases must be treated in stages, and it just so happens that this open injury of the knee joint is one of them!
The first stage of debridement and drainage + the fixation of the muscle insertion point + the fixation of the ligament start and end point, and the second stage closure of the wound.

But it's a race against time, and it has to be fast!

The third-degree debridement of the knee joint must be completed in half an hour, and welcoming the next patient into the operating room is equivalent to shortening the time of the patient next door.

"Brother Zhou Cheng, can this work?" Zhang Zhengquan was still hesitating.

"Let's do this first, I know what to do!" Zhou Cheng took a deep breath and resolutely chose to step down.

To be honest, he made this decision out of selfishness.

But Zhou Cheng's selfishness was not for his own honor or anything else, but just to keep a girl's leg!
It doesn't matter if you don't meet him, it doesn't matter much to Zhou Cheng if someone died.

but?Now that you have encountered it, what if you have the ability?
The operation of the patient next door only increases the risk of infection at most. Such infection risk can be eliminated through technology.

And must be able to accept the second stage surgery!
In this way, he did not increase his financial burden, but there was a lack of effort in the first operation.

Soon, Zhou Chengcheng came to the operating room next door, washed his hands and went on stage again!

After Du Yanjun saw Zhou Chenglai, his confidence instantly increased again!
"Brother Zhou Cheng, how is the situation next door?" Du Yanjun asked hurriedly.

"good."

"Yan Jun, get out of the way, I'll be the surgeon, you go to the opposite side, complete the operation as soon as possible, and then go to the next door to help!" Zhou Cheng could only say this to Du Yanjun in order to save time.

Du Yanjun didn't doubt that he was there, and when Zhou Cheng came again, there was no problem with him taking the lead position.

However, after Zhou Cheng quickly took over the operation, Du Yanjun didn't quite understand Zhou Cheng's operation process.Then he asked: "Brother Zhou Cheng, what did you do just now? Shouldn't you treat the fracture first, and then the soft tissue?"

Zhou Cheng looked up at Du Yanjun and said, "Yan Jun, after today's operation is over, I will find time to review the operation process with you slowly, but now, let's do things first, shall we? "

Time is precious, Zhou Cheng doesn't want to waste a quarter of an hour, and it's not that he doesn't want to teach.

Rather, Zhou Cheng felt that if he had the ability to do more good things, teaching could be supplemented later.

If Du Yanjun is Xiang Haibin, he can ignore him. He is not a friend, nor is he a teacher. No one is responsible for teaching you.But Du Yanjun and him are good friends, good brothers.

Although Du Yanjun occasionally played tricks, he never played dirty.

Moreover, he really helps when he is busy.

Real brothers, real brothers can't do it like throwing their heads and blood, which is already extremely good.

If you are too harsh on your friends, it means that you do not cherish your friends first, not that your friends are not sincere enough!
"Okay, Brother Zhou Cheng!" Although Du Yanjun didn't know why Zhou Cheng didn't want to speak on stage today, Zhou Cheng was very willing to teach on weekdays.

But I just felt that Zhou Cheng was exhausted. Last night, everyone was tired all night, so they didn't have too much energy to distract themselves!

Then, Zhou Cheng's hands flew like flying!

Broken bones and fixed bones, blood vessels are sutured, tendons are reconstructed, muscles are sutured, and there are still defects. There is no way to deal with it in the first stage, and only the second stage depends on the situation to do muscle and tendon transplantation!

The itinerant nurse was alone, under Zhou Cheng's high-speed operation, just holding and opening things, his hands and feet were a little numb!

In the end, the timing panel in the operating room showed that the operation time had reached 27 minutes.

Zhou Cheng felt a dull pain in the pad of his index finger and middle finger!
"Step down, send the patient to the ward, use piperacillin directly for antibiotics, and ask the pharmacy department for consultation to guide antibiotic treatment as soon as possible." Open joint injuries have a high chance of infection.

Even if it is grade I, it must be treated as septic arthritis, so ordinary antibiotics are definitely not enough!
"Put a plaster cast across the knee joint!" Zhou Cheng explained again when he walked out the door.

"Okay!" Du Yanjun nodded in bewilderment, feeling that what he had just experienced was simply too unreal.

He had the chief surgeon last night, but it took almost half an hour for him to sew up an incision of more than ten centimeters, debridement and suture.

Zhou Cheng here, it took half an hour to get rid of the open trauma of the knee joint?
Some of the 'fancy' operations involved here are extremely difficult, and one of them may take more than half an hour!
but?
All.

Even though Du Yanjun felt that Zhou Cheng was already very powerful and the operation was performed very quickly, seeing the result, his scalp still felt numb!

Moreover, the whole operation process did not sacrifice quality for the sake of speed, every step was done, at least within the scope of his understanding, it was done perfectly!
The plaster cast is to avoid postoperative knee joint movement, resulting in recurrent fractures and recurrent tendon ruptures that have undergone insertion reconstruction!
……

"Brother Zhou Cheng, are you back?" Zhang Zhengquan asked hurriedly when Zhou Cheng walked into the Seventeenth Room again, very surprised.

Zhou Cheng looked at what Zhang Zhengquan had done, and only completed a simple removal of the foreign body.

Zhou Cheng knew that there was still a big gap between Zhang Zhengquan's level and Du Yanjun's, although he had also cleaned up a small number of blood scabs and necrotic tissue.

but.

This level is actually very good. This kind of debridement of damage should not be an operation and difficulty that they should bear at their age.

"Ok!"

"Thank you, Quan Zi." Zhou Cheng walked slowly to the bag, and put the sterile surgical gown on his body.

"Brother Zhou Cheng, are you really done with the operation next door? Is that a third-degree open injury of the knee joint?" This is the foundation of orthopedics. Difficulty of surgery.

"Let's start the limb salvage operation, hurry up." Zhou Cheng was unwilling to explain too much.

It is now past 20:[-], and the girl was admitted to the hospital at [-]:[-] in the morning. If she had been tied up before entering the hospital, amputation would have been unavoidable.

It's a pity that she was also injured at the wrong time. At this time, it has been delayed for so long.

However, Zhou Cheng still hopes to fight.

If he still can't keep it in the end, then he has tried his best.

Then, Zhou Chengcheng started angiotomy and thrombectomy.

Next to it, Zhang Zhengquan was dumbfounded, and Zhou Chengcheng quickly took out two thrombus strips that looked like earthworms.

"Put on the tourniquet!" Zhou Cheng ordered the tour guide.

"okay!"

The tour did so immediately.

However, it takes a certain amount of time for the pressurized gas in the tourniquet to be released, so the bleeding from the wound is still not obvious.

but!

Because the little girl was injured, the wound surface was soaked very quickly, and the blood slowly leaked out, and after a while, all the wound surface was re-stained red.

Bleeding!
Surgeons love it.

Zhang Zhengquan widened his eyes and said, "Is there blood?"

Looking at Zhou Cheng, he was dumbfounded!
What Director Cai, Director Yan and the others were unable to do, was actually in Zhou Cheng's hands. Is it just that simple?How long has it been?Five or six minutes?

"Raise your legs!"

"Put on the tourniquet again." Zhou Cheng hurriedly said to Xun Xun.

The cycle of the tourniquet should not exceed one and a half hours, and then you need to rest for about 15 minutes. The total time of this operation is less than half an hour, so there is no need to rest at all!
Surgery can continue...

Zhou Cheng's voice was as expected and could not be rejected.

(End of this chapter)