medical simulator

Lu Cheng is still scrupulously continuing to operate. Although his professional title is only as an attending doctor now, he has already passed various surgical authorizations, including new operations, and can be performed routinely, as long as there are suitable diseases. exist.

Replantation of amputated limbs is generally for amputated limbs with relatively smooth stumps.

The severed limb transplantation in Chang City is aimed at people who must undergo amputation due to life-saving reasons, and then undergo transplantation of severed limbs. The target is the kind of severe ischemia for a period of time after amputation sick.

This, if successfully developed, could reduce disability for many patients.

Lower-level hospitals may not be able to save limbs, but they can amputate limbs to save their lives. After the vital signs are stabilized, the amputated limbs will be sent to higher-level hospitals, which is equivalent to dismantling the operation!

The time window in which surgery can be performed is delayed.

However, what Lu Cheng is doing now is the reconstruction of severed limbs after damage. This is another level of theory. It is more applicable to segmental damage, other positions other than staged damage, or OK.

In such cases, it is necessary to reconstruct the tissue of the damaged segment and restore the normal length of the patient's limb.

This kind of operation will be more difficult. It can be regarded as waste recycling, and it can also be dismantled and repaired, and the original normal muscle tissue can be extended in length through various methods such as thinning and splitting!

The more difficult thing to deal with is the blood vessel and nerve. The blood vessel and nerve tissue cannot be divided into bundles, so they can only be replaced by nerve branches of muscle tissue that pass through other normal nerves, but the relative role and nutrition are not important...

It sounds simple, but it actually involves a lot of high-end surgeries.

For example, just one muscle, there are muscle transplantation, muscle replantation, muscle repair, muscle plastic surgery, tendon transplantation, tendon replantation, tendon formation, tendon transposition, tendon repair, tendon suture...

Among them, the difficulty of tendon suture is relatively the easiest!

In addition to muscles, there are transposition of blood vessels, suturing of blood vessels, repair and cutting of blood vessels, and grafting of blood vessels...

Guang Yanhu was already a little fascinated.

When this patient came, the instinctive reaction of all doctors, especially those in trauma surgery, was how to save the limbs. Is it too risky?
After Guang Yanhu saw it, he just decided to keep one side of the foot, and the other side, it is best to amputate it, the possibility of keeping it is too small.

But, in fact, Guang Yanhu also knows that it is theoretically feasible to save this leg, but it will cost a lot of money. For example, Ding Changle and other orthopedic professors all appeared in the surgery. between.

It can be guaranteed, but the timing is not a coincidence.

Not to mention other professors, even those from trauma surgery must be spared.

In the 22nd room next door, Cai Dongfan forcibly sent Jinping to deal with it temporarily, and then he stayed with Guang Yanhu, giving priority to this young man.

But ah, after this young man's luck was utterly unlucky, he ushered in the biggest turning point again!

It happened to be New Year's Day, and Zhou Cheng came to Shashi for the holidays. The skills Zhou Cheng showed now could be used by at least three professors.This is not bragging.

Of course, it’s not that Zhou Cheng has three pros and cons, but that Zhou Chenghui’s skills are simply too comprehensive. If you say that bone stitching is so good, then forget it. You are so good at stitching, and the stitching is so high-quality , forget it.

Why can you suture muscles and blood vessels so well when you have no place to place microscopic instruments?
two hours later.

Guangyanhu's debridement has almost come to an end.

According to the previous arrangement, Chang Yanhu had to go to Room 22 to see the situation first.

However, Guang Yanhu, who had finished his surgery, didn't go to the next door, but sent Zhu Pei who followed him first, and went to the 22nd room next door to take a look first. He, on the other hand, got closer to Zhou Cheng. Become the opposite, personally participate in the
During the operation, and observe and learn.

From a distance, you can only see the process, and when you look closely at the details, you will know that Zhou Cheng's detailed operations are unimaginable by ordinary people, and his fingers are tactfully flying like a swimming dragon.

However, Guang Yanhu still noticed that Zhou Cheng's fingers seemed to be trembling slightly stiffly. It should be that he moved too fast in a short period of time, resulting in muscle fatigue and lactic acid accumulation!
Looking at the progress of the operation, Zhou Cheng has already completed most of the operations. The only thing left is the suturing of the outermost muscle layer. Zhou Cheng has even layered and paved the muscle tissue.

Guang Yanhu stretched out his hand and said in a low voice: "Xiao Zhou, let me sew up the rest. You can rest for a while? Stare at the side?"

It has been four hours since Zhou Cheng woke up. After such a long time, the machine should be rubbed red, let alone a human?

Guang Yanhu's operation time is the same as Zhou Cheng's, but the degree of fatigue is completely different when doing different things.

Zhou Cheng glanced at Guang Yanhu, hesitated for a while, and handed the equipment in his hand to Guang Yanhu, and he had already prepared Guang Yanhu to replace him, and changed positions back to back.

When making a fist, Zhou Cheng clearly felt that the flexor tendons in his hand were constantly trembling. The pain caused by the fibrillation made it difficult to use force, but Zhou Cheng still insisted on holding it, but the left and right hands were constantly rotating, and then another One hand stretched and stretched continuously, doing relief movements.

Only then did Cai Dongfan notice Zhou Cheng's situation, and his mind froze a little, and he said, "Xiao Zhou, you and Professor Guang can do the rest of the operation together, and you can step down and go back when you're done, I'll go and see what's going on next door first. . "

Zhou Cheng looked up at Cai Dongfan again, and said in a low voice, "Master, I'll just rest for a while. I'll go back after the operation in the next room is over. Anyway, it's time."

The surgical patients in the 22 rooms were specially greeted by the general surgeon, and Cai Dongfan ignored them. If there were any problems later, it would not be conducive to Cai Dongfan's unity with his colleagues in the hospital.

"Alright." Cai Dongfan continued to walk to the next operating room while taking off his clothes.

After leaving the operating room, on the operating table, several professors from other departments spoke one after another: "Xiao Zhou, add a WeChat later, and I can introduce you to some girls."

"Hey, Professor Ning, the girl you introduced is just a cover, you need WeChat to be real. Others Xiao Zhou already has a girlfriend. Xiao Zhou, don't add him, you add mine. I know there are many gyms in many places. Discount."

"Besides, I have a half-month experience card for the gym near the hospital. You take turns to experience it. As long as you don't go there very diligently, you probably won't need to apply for a card for a year or two, and you will go to the gym for nothing. "

"What kind of people are you all? Don't respect the old, Xiao Zhou. Let's add a WeChat later. When our surgery holds an academic conference, I will call you..."

Hearing this, Zhou Cheng raised his head and smiled at everyone, nodded and said yes, and thanked all the teachers.

Then when he focused all his attention on the operating table, Guang Yanhu said in a low voice: "These professors are looking at your strength. In the future, when they encounter difficult patients in the clinic, they hope to find you to treat them."

"Most of the severe emergency cases encountered by the Affiliated Hospital of Shonan University are fatal. If you occasionally encounter difficult emergency patients, the general hospitalist on duty is not strong enough, and you call for them in private."

"This is also a manifestation of connections. Of course, the stepping stone is that you must be recognized first."

When Guang Yanhu said this, he opened his eyes and continued to educate Zhou Cheng: "After you add WeChat later, you must note the department and name in detail, otherwise, you will be confused in the future."

"And after you go to work, these professors will also be your best working partners when you are working. It can be said that the more professors you know from other departments, the better your work will be carried out."

Zhou Cheng nodded thoughtfully.

"Thank you, Professor Guang."

Birds of a feather flock together.

Even in such a top hospital, there are different circles, there is a group between graduate students and graduate students, and between doctors and doctors is the network of contacts.
Introductory information, attending consultation, associate professors discuss how to be promoted to professor, and enjoy life.

Among the professors, they think more about how to make the patients in their own groups and departments survive, and what channels and resources can be used to solve various complications!

"In real clinical practice, no patient will get sick according to the textbook, and it will not be just a simple disease. At this time, consultation is very important. This is especially true for consultations in some internal medicine departments."

"Also, the network in the anesthesiology department is the most fundamental background of a surgeon. What kind of patients, what kind of anesthesiologists dare to speak up, and what kind of patients, the anesthesiology department dare not speak up. It depends on the individual!" Guang Yanhu continued.

However, while Guangyanhu was talking, he saw that Zhou Cheng pulled out the unknotted thread that he had just sewed up, and then used tweezers to rearrange it, exposing the layers of Guangyanhu's stitching. It was too deep, and it hit a small artery.

"Thank you Professor Guang for your guidance." Zhou Cheng's tone was still sincere, and he didn't start playing any tune just because he had just corrected Guang Yanhu's mistake.

Guangyanhu was actually a little embarrassed, and Guangyanhu saw it, and the Zhupei next to Zhou Cheng looked in shock, as if he couldn't believe it at all, Zhou Cheng dared to tear Guangyanhu's stitches , and it is even more unimaginable that Guang Yanhu, the technical director in the group, will also make mistakes.

Guang Yanhu blushed even more embarrassed.

Taking a deep breath, he resumed sewing, only more focused.

Another 40 minutes later, Guang Yanhu looked at his finished wound, raised his head and asked, "Xiao Zhou, is this all right?"

Asking this question is like a student.

During the whole suturing process, Zhou Cheng corrected his mistakes three times. The second time, he was careless, but the third time, Guang Yanhu really did not expect that Zhou Cheng could notice the blood vessel that was not much bigger than a hair. Cavity!
"It should be fine for the time being." Zhou Cheng felt the normal beating of the dorsalis pedis artery and breathed a sigh of relief.

"VAC coverage, skin grafting can only wait for the second phase. For this patient, the bacterial culture results must be followed up every day after the operation, and the antibiotics should be adjusted at any time. After returning home, Vancoma will be used once, and piperacillin will be used for routine antibiotics. Cephalosporins will be used temporarily. no need."

For such a patient, if the antibiotics were not used enough in the early stage, if an infection occurs and the emulsification of the soft tissue is caused, then next time, there is really no chance of limb salvage.

At this time, the amount and level of antibiotics used must be higher.

Guang Yanhu did not express his disagreement, but only confessed: "Intravenous vancomycin can only be prescribed with Professor Cai's job number. After the prescription is completed, immediately ask the pharmacy department for consultation, explain the situation, and ask the pharmacy department for a follow-up consultation. Opinion!"

"Okay, Professor Guang." Zhu Pei hurriedly nodded.

After Zhou Cheng and Guang Yanhu finished posting the VAC, they left the stage first, and then left Zhupei here to temporarily watch the situation of the VAC negative pressure sucking blood.

However, although the orthopedic surgery is over, the general surgery is not over yet, so those professors who were scrambling to get Zhou Cheng's contact information before are all concentrating on the operation at the moment, and are not distracted by Zhou Cheng's resignation .

Zhou Cheng took another look and found that there was nothing dangerous about the patient, so he breathed a sigh of relief.

Fortunately, some difficulties have been overcome, and I hope that life will be fine, that he can wake up routinely, and then not be infected, then this child can still be rescued.

In case of infection or other accidents, there is really no way.

When manpower is scarce!
All that's left is to pray.

Then, Zhou Cheng came to Room 22, but just after entering, Zhou Cheng found that the smell in the operating room was a bit wrong.

"Professor Cai, where are your orthopedic staff? Haven't you come yet?" A voice urged.

"Aren't we from the orthopedics department? Since when is there no orthopedics specialist for this operation?"

"I mean that Zhou Chengle, Professor Cai, don't embarrass me, this
What's going on now?When is this, can you keep your legs? "His tone is a little bit weird.

"Zhou Cheng is not yet an official employee of our orthopedics department." Cai Dongfan's tone was calm, and he didn't take the other party's words seriously at all.

"Then I heard that he operated in operating room 21 before?" The voice in the sterile surgical gown was slightly stagnant.

"The condition in the operating room next door is even worse!" Cai Dongfan frowned.

"I also heard that the operating room next door is a relative of Professor Cai?" Another voice was even more disbelieving.

"Professor Chang, would you like me to bring you the genealogy?" Cai Dongfan said this out of impatience.

Professor Chang's eyes were also cold, and he began to look serious: "Professor Cai, anyway, this is a patient of your orthopedics department, and it is also a matter of your orthopedics department. You should take full responsibility yourself."

Chang Lilong knew that Cai Dongfan didn't take his greetings seriously at all, which made him very upset, but it was not easy to get angry.

"Otherwise, Professor Chang, you will be in charge?" Cai Dongfan asked with a straight face.

Hearing this, Zhou Cheng walked out of the operating room decisively and went downstairs!

He is not a prostitute, and he does not serve everyone.