medical simulator

Chapter 425
The road to medicine is long and difficult.

Even after graduating from a bachelor's degree, they just stay outside the door!

After studying as a graduate student, in the same department, between different sub-specialties, I feel that there is a wall between them, and I feel that they are two unfamiliar fields.

Even when it comes to professors, there are blind spots in understanding between professors of different subspecialties!
A person's life is only so long. Even if he spends his whole life, he can only blame himself for slowly studying in a sub-specialty. Basically, he rarely has spare time to master and familiarize himself with the operations and knowledge of other sub-specialties.

Because every subspecialty is deep enough.

Trauma, hand surgery, joints, sports medicine, bone disease, ankle, which one is not as deep as the sea, simple, or all-round, they are all laymen, and they have never read it...

No, it's not enough. If you really want to subdivide it, you can still divide it.

Orthopedics, chronic injuries, nerve transplantation, sports rehabilitation...

Every subject that is subdivided and divided is enough for a doctor to study for a lifetime!

This still feels a bit forced, but some people actually think that there is a discipline that can solve all diseases in various departments such as internal and external women, children, ear, nose, throat and oral cavity. Isn't this bullshit?
There are not so few diseases in medicine!
Every disease is not so obvious.

It's not as typical as it is written in the textbook.

In fact, sometimes the more Zhou Cheng learns, the more afraid he becomes, and the more confused he feels.

Zhou Cheng can understand Huang Xuanqi's current sense of powerlessness,
Zhou Cheng didn't teach Huang Xuanqi as an ordinary student, at least not now: "Old Huang? For this kind of fracture of the tibial shaft, both the ring external fixation bracket and the triangular bracket are fine, and the upper connecting bracket is the choice."

"We're going to put on a tripod today."

"Let go of your hands first, let's prepare something for the external fixation bracket together."

Zhou Cheng was quite tactful, because he was afraid that Huang Xuanqi would not know what to use for the external fixator.

It doesn't matter if you don't know, you can learn slowly, for fear that Huang Xuanqi will feel burdened.

Huang Xuanqi's heart fluctuated, but he quickly adjusted his mentality.

In a person's life, he has to learn to return to zero many times.

Learn from scratch, learn slowly, learn one, gain one, understand one, and one more.

After straightening his mentality, Huang Xuanqi felt a lot more free and easy in an instant. He watched Zhou Cheng find a set of external fixation equipment seriously, and remembered them all in his heart.

Bone fixation nail, connecting rod, connecting rod fixing cap.

Zhou Cheng only took one bone fixation cap and a fixation cap, compared them on the operating table, and then ordered: "Old Huang, bring seven more of this combination."

"We need to put three fixation nails on the proximal and distal ends of the fracture at the same time, and then form a triangle to put two fixation nails,"

"After connecting with two connecting rods, two stable incomplete triangles are formed, which can achieve the best fixed position."

Huang Xuanqi nodded frequently, and quickly got the two connecting rods and the remaining seven fixing nails and fixing caps.

The anesthetist watched the two students of similar age interacting on stage, as if they were watching a play.

Zhou Cheng made the opening and installed the fixing nails on the electric drill: "I'll drill two. You are very strong, how many more?!"

Zhou Cheng was almost feeding.

"Okay!" Huang Xuanqi only said one word, but the meaning was contained in this word.

Now Zhou Cheng is not only a classmate, but also a teacher.

Learn to have this attitude.

"When placing the fixation nail, we must pay attention to inserting the needle perpendicular to the bone cortex, and choose the position in the anterior area of ​​the tibia."

"From front to back, this is the best way to avoid hitting nerves and blood vessels, but be careful not to hit the outside of the tibialis anterior muscle, because this is where the anterior tibial artery goes..."

Zhou Cheng explained that there are no details.

First things first, Zhou Cheng accurately inserted the nail into the bone, and stopped inserting the nail immediately after two breakthroughs.

Then use a special handle to completely embed the screw thread of the fixing nail under the skin, and at this time, the best fixing effect can be achieved.

After reading it, Huang Xuanqi said, "If you see it clearly, there should be no problem."

Of course Zhou Cheng was not particularly relieved, and continued to talk about some key points:
"You fix the distal end of the tibia first, and make it straight with the nail layer I put in, and use the connecting rod to make the alignment, so it can't be deviated."

"Finally, the position of the fixing cap is reserved. For such a fracture, we need to make two semi-open triangles, so the position of the fixing cap should be reserved on the inner side of the fixing rod."

Huang Xuanqi tilted his head and smiled: "Can we slow down?"

"Okay!" Zhou Cheng understood very well, and slowed down his speech a little...

Huang Xuanqi picked up the sharp knife and cut open the skin steadily with his hands, then bluntly separated the subcutaneous tissue to the bone surface with curved forceps, and then accurately inserted the fixing nails with an electric drill.

There was a non-stop sound of the nail rubbing against the bone.

But Huang Xuanqi's hands didn't even shake, and he focused on the changes in his voice.

After two breakthroughs, he stopped immediately, and then used the handle to feed the pin into the tightest position.

After doing so, he breathed a sigh of relief——

In fact, the external fixation bracket is not as difficult as imagined.

The key is that Zhou Cheng's guidance is very good, so I don't need to panic.

With the first nail, the second nail was easy. He carefully looked at the X-ray again, and after confirming the location of the fracture, he took a place about 3cm below the fracture line and broke the skin again...

Six minutes later, Huang Xuanqi finished six nails on the front of the tibia.

Zhou Chengcai said: "The fixing cap fixes the connecting rod. Lower and fix one side, and then drive in the remaining two fixing nails from a direction about 45-90 degrees to the side of the connecting rod now, and then fix the connecting rod!" "

"This forms a semi-open triangle, which can also be stabilized."

"Okay!~Brother Cheng, let's go up together and save some time for the patient." Huang Xuanqi said so.

This surprised Zhou Cheng, Huang Xuanqi still knew that it was best not to waste time on a patient when practicing hands.

The difficulty of external fixation surgery lies in positioning and judging the fracture type, and screwing is actually a practice operation. Knowing how to screw is the key.

There is no need to waste too much time for repetitive operations, and slowly use time to accumulate.

After the external fixator was installed, Zhou Chengcheng asked Huang Xuanqi to debride the wound.

The debridement operation is quite simple.

At the end of the operation, Zhou Cheng took care of Huang Xuanqi's operation a little bit, and then used VAC negative pressure suction.

When the patient is on the push bed, he can be sent directly to the department!
Huang Xuanqi smiled knowingly: "This feeling is really refreshing."

Zhou Cheng's heart moved, thinking of the first two years of his residency.

"The sense of participation is directly proportional to the harvest. Is it okay?" Zhou Cheng looked at Huang Xuanqi.

The excited and happy expression at this moment can't be concealed at all.

This should be the first operation in which he actively participated in a relatively critical operation.
Moreover, Huang Xuanqi's operational ability and talent are not bad at all, it's just that he usually gets too few opportunities!

This is where lower-level hospitals are more helpless. The higher-ups are unwilling to give you the bottom line, and you have nothing to do. You can only do what you can, and then take responsibility for yourself.

When you encounter difficulties, the only person you can ask is yourself. Others will only solve the problem for you, not teach you how to solve it.

Huang Xuanqi's hands were also very steady, basically not shaking much!
Such a chief surgeon has a strong psychological quality. After working in the future, he will

Definitely an excellent surgeon too.

"But I'm still a little tired." Huang Xuanqi smiled innocently.

He wiped the sweat from his brow and sniffed his nose.

It was the first time I put on the external fixation bracket. If I was not nervous, I must have pretended it. In fact, my forehead was already covered with fine sweat.

"It's okay, take your time."

"If you have time, you can apply with your master to stay here for a few months, and see if he agrees." Zhou Cheng led Huang Xuanqi towards the sink outside the operating room!

Then he said: "Old Huang, don't be too restrained, you can be more comfortable."

"Of course I am, Brother Cheng. In our hospital, you are the child of someone else's family in our hospital. My master has mentioned you more than once. I just don't dare to admit that it is my brother?"

"If I had known it was you earlier, I would have come to you when I f*** retested?"

Zhou Cheng smiled wryly when he heard this, and said, "Are you looking for me during the retest? I don't think anyone here knows me yet!"

Huang Xuanqi's re-examination should be after the end of last year. At that time, he was still preparing for his doctoral defense, and his influence in the Department of Orthopedics of the Affiliated Hospital of Shonan University was really limited.

In fact, it is very limited now.

"Huh?" Huang Xuanqi was taken aback!
In a year, you have become like this now?

However, before Zhou Cheng could answer, the hospital's phone rang.

Huang Xuanqi didn't leave anymore, he happened to be in the surgery class.

……

After about an hour and a half.

Zhou Cheng and Huang Xuanqi came from the surgery building.

The seventh operating room came out, and then sat down limply outside the operating room.

Emergency operations are generally arranged in emergency operating rooms as much as possible, and then arranged from operating rooms 1-10 in the surgical building.

This was already the fourth emergency operation performed by Zhou Cheng and Huang Xuanqi.

Open fractures, tibial nerve exploration, replantation of severed fingers, and the one just now, sutured with tendons.

"It's so tiring, Brother Cheng, isn't it easy for you?" Huang Xuanqi sighed.

Zhou Cheng not only had to consult, but also had to perform surgery. Huang Xuanqi felt that such a workload was difficult, and Zhou Cheng was able to take care of everything.

Especially for the tendon suturing of the last machine, Zhou Cheng was doing the whole process!

The total number of sutures is at least one or two hundred stitches!
This stitching is not like sewing clothes, it is a test for eyes and hands,

"I'm a little tired!" Zhou Cheng tore off the mask, his mouth dried up into a shell, and he moistened it with his tongue.

Huang Xuanqi sat for a while, then got up again and said, "I'm going to buy some drinks."

Zhou Cheng said: "No need, let's go to have a late-night snack, and I will arrange the rest of the emergency surgery to be hospitalized by other generals."

Ding Changle had confessed that he would give other hospital chiefs a chance to practice.

If it wasn't for Huang Xuanqi, Zhou Cheng wouldn't have to go to the emergency room for surgery, and deal with some minor problems, and then hand them over to the bosses of other departments.

Moreover, it is impossible for Huang Xuanqi to buy it. Now that Huang Xuanqi is studying, he is paid.

"That's okay, I'll go down and book a seat first." Huang Xuanqi thought that Zhou Cheng was hinting something to him.

"Okay, you make a reservation, but you agreed to treat me. As I said before, you have to call me when you come to Shashi. You didn't follow the first rule, but you can't break the rules of treating guests."

"Okay. Ci'ao!" Huang Xuanqi accepted Zhou Cheng's pretentiousness cursingly.

Zhou Cheng sat at the door of the operating room and continued to relax.

Then when I was about to stand up and stand up.

The itinerant nurses in the six operating rooms of the emergency operating room ran out to get consumables and saw Zhou Cheng sitting at the door!

His eyes widened and he asked, "Are you done again? This is the second station, right?"

The previous operating room was in the emergency operating room.

Zhou Cheng raised his head and grinned: "Yes, Miss Kong."

The tour guide named Kong Ling immediately covered her forehead: "Which god are you? Can you show some respect to emergency surgery?"

"Two sets in an hour and a half, no wonder sister Xuanxuan went back to rest. It's late at night, how about you play?"

"Ah? Who? Who did two emergency services in one and a half hours?" While Kong Ling was speaking, a man in green clothes came out of six operating rooms.

Kong Ling said: "Here, Brother Yu. You don't know, the Department of Orthopedics occupies two operating rooms in our operating room today. It is also the replantation of severed fingers. He completed one, and added another one for debridement or tendon suture. , and the other one only connected two fingers."

"There are three broken fingers over there, and there are five severed fingers here. Just say it, this little motor is the same."

"The one that just ended was suturing the tendons of four fingers, 46 minutes."

"I'll just say why Sister Xuan told me that he was tired."

Zhou Cheng also apologized a little apologetically, "It's not that I want everyone to get off work earlier."

Zhou Cheng supported himself and stood up: "I'll go back first, brother, sister Kong, you should get off work early."

"Zhou Yu, you and I are from the same family."

"I'm in the Department of Urology. Brother, if you have any problems in this area, I can give you some guidance. Haha!" The green suit named Zhou Yu seemed to be very good at playing, so he made a joke.

When Zhou Cheng heard this, he immediately laughed back: "Whether it's guidance or fingering, it's not for Nan Haizi, is it? It's called finger circle at most."

After finishing speaking, Zhou Cheng walked over regardless of whether Zhou Yu from his family could understand or not.

Zhou Yu was stunned for a moment, and then shouted from a distance: "That's interesting, brother, you have used up another word in the complete collection of words."

Zhou Cheng didn't respond.

Kong Ling asked, "Are you driving again? Why didn't I understand?"

She thought she had seen a lot of speed battles between surgeons, but she never heard that there was a problem?

"Sister Ling, will you leave a finger when you dye your nails?" Zhou Yu explained in a very cryptic manner.

Kong Ling suddenly realized, but she didn't mean to blush. She is also a person who has been in the racing circuit for a long time, and said: "I never do nails."

"I'm going to get something."

Zhou Yu stretched, and then walked outside the operating room. His operation was nearing completion, and the rest was left to graduate students. He was going to take a rest.

But after walking a few steps, I heard another stone patient came to the emergency department: "Tell him to go back to drink water, or use some dilators."

"What, so big? 3.0? Are you kidding me?"

"Okay, I'll come down and have a look."

For kidney stones of 3.0 cm, conservative treatment is definitely not useful.Zhou Yu ran down, his figure disappeared in the passageway of the operating room, and he turned into a laborer at night...

(End of this chapter)