Nineteenth Century Medical Guide

Chapter 387 383. Take it from Ding, use it with Ding

Berget has been with Kawei for a long time. He went from being so panicked when he first came on stage that he didn't know what to do to now being able to clean, disinfect, and suture all kinds of wounds proficiently. His progress is the most obvious.

Just looking at the anastomosis of the wound, the skin is well aligned, the needle is placed cleanly, and the thread take-up force is moderate. The whole process does not take much time, so it can be considered skillful. But overall, both Berget and Cediyo ignored a very important key issue, the integrity of the skin.

Kavi was a little disappointed.

The two of them had experienced so many post-burn skin plastic surgeries in Paris, so they should have some plastic surgery awareness. Unexpectedly, in the end, I stepped on the pit that I shouldn't have stepped on.

The special shape of the penis determines that its suturing is different from that of ordinary incisions. Especially for cross-sections like Gezer's that were bitten by animals, special attention must be paid during suturing.

Kawei's reaction interrupted the operation and made the onlookers feel strange.

Judging from the news coming out of Austria and France, Kawei has always been synonymous with success, and several operations in Switzerland were also very successful. No one thought that his operation would go wrong in the final stages. Even if someone else performs the suturing, as the chief surgeon, he will always bear the primary responsibility.

But no matter how the final stitching goes, it is better to sew it on than to cut it off.

Fortunately, this is a public surgery, and there are always some non-professionals who cannot clearly see the surgical situation and interpret sarcastic remarks as praise. As untimely applause broke out from a corner, the atmosphere in the venue became increasingly strange. Many people began to rely on the "Celebrate Christmas" banner hanging at the entrance of the theater, and under the catalysis of alcohol, they inexplicably praised Gezer's Tintin:

"What a powerful penis!"

Once someone starts speaking, their words will become more and more outrageous, and they will even use many obscene words that are hard to hear in order to show their uniqueness.

"He is confused, and so are you."

Kawei roughly guessed what he meant: "Be more specific."

Kawi glanced at Cediyo, then turned around and admitted his "mistake" to the audience: "We misjudged the wound, thinking that the horse's teeth were like the blade and could cut the skin smoothly. Now it seems that this "It's not a simple cut, it's more like a contusion with partial skin avulsion."

As long as there is a direction, surgeons like Cedieu, who have been working in clinical practice for decades, will quickly think of a solution when they encounter some troubles: "Otherwise, it would be like doing a syphilitic nose reconstruction surgery. "

The sleeping memories of the two were awakened, and their eyes began to wander back and forth around Tintin. Cediyo immediately found a suitable location: "If we need to maintain the original appearance, should we cut the skin underneath and move it to the defect?"

"This is my first time sewing something like this. I've always cut it off before. I have no experience."

Sediyo picked up Gezer's penis, picked up a pair of hemostats and pointed it at the bottom of the vaginal sac: "Make 2 parallel transverse incisions in the middle of the vaginal sac, the width is equivalent to the width of the defect, the length is based on the size of the penis, and then free this place skin, forming tunnels"

Kawei didn’t know what to say about them. One was the Chief of Surgery and the other was the Austrian Viscount. It was definitely inappropriate to use a modern tone of slamming the table and scolding the mother: “They are all sewn into such obvious obtuse angles. They look like golf clubs. You guys How will he behave in the future?"

As he spoke, he raised his arms high and pressed the tip of his nose against the skin of his upper arm: "I've seen people do it before, using the skin of the upper arm to bridge the bridge of the nose, but it takes a while to grow well."

"The idea is good," Kawei explained, "but the locations are a bit far away. One is near the coronal sulcus and the other is in the genital sac. Moreover, the defect is not large, so there is no need for such a large skin graft."

First, I apologized to admit my mistake, and what I said was more realistic: "When suturing, I found that the epidermis may be defective, and suturing will be difficult. I have tried to reduce the skin tension as much as possible, but I didn't expect it to become so bad in the end." serious."

Maybe after working as a director for a long time, Cediyo was reluctant to let go of the burden. Just like when he had a gastrectomy, he always liked to make excuses for failure. Berget knew Kavi better and knew that there was no point in excusing himself, and the title of viscount on his head was worthless in the eyes of the other party, so the answer seemed to be too many.

“What should you do if you have a defect in the skin?” Kavey reminded. “Think about all the surgeries I had in Paris.”

"It's so tall and straight, it's as enviable as the Christmas trees in the homes of princes and nobles!"

He did not specify the specific location, but his finger was pointing to the vaginal bursa below: "The reason is very simple, because the vaginal bursa can be large or small, remove some epidermis, as long as the alignment suture is done, it will not affect daily life. If the suture technology If done properly, the patient may not even feel the skin defect.”

"Why are you so stubborn? Paris has done so many skin flap transplants and you have forgotten about them?"

"Doing a transfer flap?"

But there is no point in just admitting mistakes. The key is to solve the problem.

Rost, who was chatting with others at the door, realized something was wrong and quickly came in to interrupt them: "Quiet! Everyone, please be quiet! There are some minor problems with the operation and it's not over yet! Dr. Kawei is actively handling it, please don't interfere. to him!"

This kind of noise is far less than the artillery fire on the front line of Olmitz Fortress, and it is not enough to distract Kavi. He approached the operating table, put on his gloves again, lifted the penis skin with tweezers, and looked at the sutures carefully:

Kawei immediately understood what he meant: "Do you want to bury the entire penis under the skin of the vagina?"

"Yes, after burying it, use silk thread to suture the skin of the defect and the skin of the tunnel, and then use a dressing to wrap and fix the entire penis."

"This"

Kavi has seen this type of surgery before. It is a treatment method used when there is a large area of ​​skin defect on the penis. The method is very good, and it is basically like modern urology, but it also has many disadvantages when dealing with small defects.

"To do this, we need to keep him immobilized for about a month." Kawei raised his head and glanced at Geizer, who was still sleeping. "Our patient is too active, so we probably can't wait that long. In addition, we also have to consider the urination problem. When folded like this, urinating becomes difficult.”

Cediyo was silent for a moment: "You can choose to have a cystostomy, just like the way Alphonse was treated."

"No, no, no, Professor Sedieu, you have fallen into a misunderstanding." Kawei explained, "I have repeatedly emphasized that surgery is invasive and can cause very serious damage to the body. If you want to deal with such a small gap, , Isn’t it strange that I ended up having to have an ostomy?”

Cediyo and Berget were lost in thought.

Kawei continued: "And stoma cannot solve all problems. This is a young man in his 20s, so he will inevitably be impulsive. What should I do if I encounter a boki? Can I guarantee that the tunnel suture will not split?"

Of course, Cediyo didn't expect that much, even infection and skin necrosis might not be able to be solved, let alone that a hundred years later, doctors would be able to suppress the patient's impulses by using sedatives and estrogen.

After going around in circles, the problem is still not solved.

"Can we just leave it alone and wait for the wound to recover before doing the second-stage correction?" Bergt put forward his own opinion.

"How to correct it?" "Remove the scar after incision, and then" Begert had a very vague concept in his mind, but he couldn't describe it in words, "and then use the same incision as the previous eyelid surgery, by changing the position. to maintain tightness.”

Kawei knew that he was talking about the "Z" plasty, which is commonly used in plastic surgery, but it is not good to use it here: "You said there are scars and scar contracture. This cannot complete the right angle. Can he bear it?"

Seeing that neither of them could do anything, Kawei moved the tweezers to the front end: "It's also a skin graft, but the vaginal capsule is too far away. If you move the penis, it will change the original angle of the penis, and the postoperative treatment will be very troublesome. But there is a place The skin has a lot of mobility, so you can use it anytime.”

"foreskin?"

Kawei lifted up Gezer's penis and pushed it back gently with his hand. He immediately encountered unprecedented resistance: "Okay, I take back what I just said. This brother has some phimosis and the foreskin is not very mobile. Berget , give him some more ether. Nurse, please give me the scissors."

The surgical steps are not complicated. You only need to cut the foreskin longitudinally from the dorsal side, then turn it back, cut it close to the skin of the defect, and finally suture it.

The operation soon came to an end, and Kawei saved Tintin, who was almost at a right angle. Without foreskin repair, Geize would never be able to use it in his life, and he would even suffer from urethral stricture in his later years.

The surgery was successful for all.

Kawi used actual cases to convey the concepts of modern plastic surgery to Sedillo and Bergert, and the two indeed gained a lot of experience. Rost successfully attracted the attention of many important people and negotiated two business deals. Old Knissel successfully showed his face and was praised by newspapers afterwards as an approachable and good chairman.

Those Zurich people who won the civilian tickets were also successful. They watched a grand performance for free and met the beautiful Queen Elizabeth, which made the ordinary Christmas a little more festive. Not to mention Geize, meeting Kawei was definitely the greatest blessing in his life.

The only ones who seemed unhappy were Elizabeth, Lily and the two guard captains.

And their gloominess is not exactly the same.

Lily is distressed that she must give up Elizabeth while falling in love. Especially now that Austria-Hungary relations are very bad, there are fewer and fewer Hungarians around Elizabeth, and she is worried about the queen's mental condition.

The two guard captains were worried that there were no more Hungarians in the team. Whether they could convince the crowd was another matter. The key was that they did not speak German well. How to improve communication within the team became the most urgent problem to be solved. Of course, they were also worried about whether their seats would be secure. After all, Mick was always tight-lipped and would never promise them anything.

Elizabeth is worried about how to find a balance between her identity and the rights of Hungarians, while also facing the pressure brought by Mick. It can be said that the more she likes Hungary, the more painful she becomes. The Hungarian problem became a thorn in her side and must be resolved as soon as possible.

Since taking back Rudolph's educational rights, Elizabeth has become much stronger and will not blindly choose to avoid trouble.

After the operation, she went out of her way to find Kavi and Skoda. After confirming that she was in good health, she decided to rush to Budapest immediately after waiting for a reply from Franz and Andrassy.

The news immediately reached Mick's ears.

Mick did not object or make any suggestions, but was very disciplined and responsible for his own security work. Elizabeth didn't have any conflict with him. She casually asked a question about the guard. After getting a similar answer, the conversation ended.

After the travel date was basically determined, the Queen's entourage also became tense due to the tension between Austria and Hungary.

Only Kawi remained outside them.

What he wants to know most now is not when he will leave, but why Mick didn't come to see him after leaving without saying goodbye.

For the first time, Mick was forced into the room by Kawei and had to sit down and have a good chat about his physical condition: "This is Cusper, whom you met in the old city before."

Kawei had indeed seen him before, and that was the day he was invited back to his original rental house from the station. But he didn't remember the exact appearance of this guy. He only knew that he had a pretty face, but he had no other impression. If Mick hadn't mentioned it specifically now, Kawei would still be in the dark.

"It's him?"

"Just tell me what you have to say." Mick sat on the chair, covering his stomach unconsciously with his hands. Seeing that Kavi was still hesitant, he said, "Cusper is my half son and one of my own, it doesn't matter. "

"You are very ill." Kawei got straight to the point, "I can help you."

"No need, Dr. Kawei, my body knows best." Mick consciously took his hand back and took the hot water from Cusper with a smile, "It's just a stomachache. Eat something and it will be fine." of."

"No way, eating will only make you feel more pain."

Mick knew he couldn't convince him, so he immediately changed the subject: "Then how do you want to be treated?"

"Operation."

"Will it succeed?"

Kawei sighed: "Not necessarily, but I think I can give it a try."

"No, my job does not allow such probabilistic events to exist." Mick directly rejected his proposal, "If you give me medicine, I can still accept it."

Even in modern times, there are only a handful of drugs that can truly cure gastric cancer. Not only do they strictly limit the types of tumors, but they also cost a lot of money.

"There is no medicine, the only option is surgery, but I am sure it can be cured, really!"

"No, you didn't, I'm sure of this." Mick stood up and made a gesture of invitation, "I'm really sorry, Dr. Carvey, but I refuse surgery."

"Now that you have found me, you are my patient."

Kawei is still the same, unwilling to give up on any of the patients he identifies. Unfortunately, what he encountered this time was an iron plate, and he was not given a chance at all: "Casper, see the guest off."

"Dr. Kawei and Teacher Mick have already said, please come back."

Cusper was far crazier than Mick. He didn't use gestures to see off guests but the dagger in his hand: "Don't force me to use force."

(End of this chapter)