Gou is practicing medicine in the clinic

Chapter 257 Skin Grafting, Deputy Chief Physician Jin

After receiving the money, the registration was done according to the regulations, and a surgical risk notification was issued for the family members and patients to sign.

Li Jingsheng arranged surgery for him on the spot.

There are no other requirements before the operation. You need to shave your beard and brush your teeth.

For a fee of 2000 yuan, disposable toothpaste and toothbrushes were provided by the clinic.

This part of service must be done well.

Watching the young man into the operating room, his stepfather chased after him.

"Please take your time!"

He only said one word to Li Jingsheng, his eyes full of sincerity.

"I will. Please rest assured, you and auntie, sit outside and rest for a while."

Li Jingsheng specially placed a row of benches outside the operating room, which can seat six people in total.

Since it is an outpatient operation, it is relatively loose in terms of aseptic management.

Different from the operating room in the inpatient department, the management there is more strict. Patients are generally required to bathe and change clothes, and then the doctor or nurse will push the patient in.

Now it is basically done and asked the family members to push the patient outside the designated operating room to wait.

When it was the turn of the queue, the medical staff took the patient into the operating room.

Some surgeries require the patient not to wear clothes, which can usually be taken off by the nurse after entering the pre-anesthesia room.

Especially female patients.

Sometimes when encountering individual interns who want to save trouble, they will ask to take it off outside, and then push in after putting on a list.

I believe that many female patients will find it difficult to accept.

In fact, it can be refused.

Many people think that the operating room is sterile, this view is not correct.

Even the best [-]-level laminar flow operating room cannot be absolutely sterile.

It can only be relatively clean.

Li Jingsheng's clinic now has a dedicated operating room, which is strictly disinfected before each operation, and the operations during the operation are also performed in strict accordance with the regulations.

This kind of operation is completely in line with the requirements.

"Boss, what sleeping position do you want him to take?"

"Take the supine position!"

For this operation, Li Jingsheng brought only two people, one was Han Siying, who was his medical assistant.

One is Munro, a full-time surgical nurse.

"Is local anesthesia okay?"

"absolutely okay!"

Li Jingsheng had already put on his gloves and changed into his surgical gown.

The operating room of his clinic does not have a pre-anesthesia room, but there are changing rooms.

Anyway, something like that.

If he wants to build better, he must wait until he makes money later.I have to at least buy this yard before I would consider it.

Otherwise, when the lease expires, if he is asked to move out, wouldn't the decoration of the operating room be for nothing?

The price of decorating the operating room according to high standards is not cheap.

The lowest cost is 500 yuan/square meter, and the expensive ones are so expensive.

The two laminar flow operating rooms built in the Second Hospital were built using the back molars.
It is conceivable that it is possible for him, a clinic owner, to build this kind of operating room?
After placing the patient in a supine position, begin applying drapes and then perform local anesthesia.
These are operated by Monroe.
To keep her, Li Jingsheng made a very wise choice.
For this operation, if it is a child, general anesthesia is generally required.
Then his clinic can't do this surgery.
Anesthesia for adults is fine.

"Siying, pull his mouth away."

Li Jingsheng couldn't help but think of Tang Ping, who used to perform cheek abscess surgery on a female patient and worked as a nurse and a doctor's assistant.

At that time, the clinic was just starting, and everything was difficult.

The equipment is extremely simple.

Compared with then, it is so much better now.

After pulling the patient's mouth open with a hook, the mass under the patient's oral mucosa can be clearly seen.

"Pull away and hold. Munro, give me the scalpel."

Meng Luo handed the scalpel to Li Jingsheng.

He chose to cut the mucosa from a position two to three millimeters from the periphery of the lesion.

The advanced cutting method allows him to easily grasp the depth of the cut.

You can really cut as deep as you want.

However, when encountering some cutting or separation that is as fine as millimeter level, it is still difficult for him to control it accurately.

Because this difficulty is too high.

It is estimated that you have to reach a higher level to be competent.

His current doctor level is a senior attending physician, and he still needs more than 2000 experience points to advance to the next level.

It is really not an ordinary difficulty to be promoted to deputy high school.

However, he has been working hard to accumulate health points in the past few days, preparing to upgrade his doctor level by one level before participating in the skills competition.

At least the deputy director level is enough to see it.

At that time, all the experts from major hospitals will come. The stronger he is, the easier it is to win glory for the Second Hospital.

Last week, Director Zhong Hu found him privately and wanted to find him as a medical assistant.

Because Director Zhong Hu is indeed a bit miserable, and he doesn't have a capable assistant.

That's why Professor Wu poked at his pain point last time, and immediately made Director Zhong Hu so angry that he rolled up his sleeves and wanted to fight.

Everyone has pain points and weaknesses.

It's strange if you don't get angry when you are exposed in public.

After Li Jingsheng carefully incised the oral mucosa of the patient's lesion, he found that the lesion had involved the parotid duct orifice.

Immediately cut carefully around the opening of the catheter.

Fortunately, his current sharp separation and incision are very powerful, otherwise this operation would probably be messed up.

If after the operation, this young man from society drools every day, I'm afraid he will directly smash his clinic.

After careful inspection, no erythema was found.

The feeling is more likely to be benign.

Clinically, if erythema is found in the lesion, it is usually treated as a malignant tumor.

The incision needs to be enlarged, and the resection site should be at least 5 mm larger than the lesion.

He separates the lesion little by little and then excises it.

The whole process seemed extremely calm.

When cutting the lesion, the incision went all the way to the buccal muscle, and the entire lesion was removed.

At this time, a large defect wound appeared.

He was a bit confused about the treatment of the wound.

If you directly pull and suture, the patient's wound can be sutured, but after healing, it will be difficult for the young man to open his mouth.

Eating, talking, and yawning will all become obstacles.

Because his mouth can only open a little bit.

The main reason is that the lesion is too large, and after incision, a large wound is formed.

what can we do about it?

Li Jingsheng is a responsible doctor who not only ensures the effect of surgical resection, but also considers the patient's postoperative life.

The postoperative quality of life of patients should not be affected by this operation.

"Young man, you also saw the cut tumor, which is very large. Now you need to suture the wound. If you suture it directly, you will have difficulty opening your mouth when eating or speaking in the future, and you can only open it a little. I have a plan here. , that is to transplant a piece of skin from your arm. If you agree, just blink." Li Jingsheng asked the patient for his opinion.

The boy blinked his eyes in agreement.

In order to avoid postoperative disputes, Li Jingsheng recorded all this.

It is not the first time he has removed a tumor.

However, this is the first time for surgical skin removal and skin grafting.

Fortunately, the suturing technique is very good, and the incision and separation techniques are also very good, so this seemingly uncomplicated surgical operation can be completed.

If I had known that skin grafting was needed, I would have charged at least 600 yuan more.

There is no other way now, the right is to do good deeds.

Otherwise, if you temporarily increase the price on the operating table, wouldn't it become a black clinic?
Li Jingsheng wouldn't lose a lot for a few hundred dollars.

First, the brachial plexus anesthesia was given to the young man, and then the skin was removed.

The entire skin removal process was smooth and hassle-free.

The difficulty is quite high, especially the size and shape, which need to be well grasped.

After taking the skin, Li Jingsheng sewed the skin to the wound.

Fortunately, the cortex was taken from the inner side of the upper arm, otherwise, there would be no way to get the green dragon in his hand.

Therefore, if you are not from the society, there is really no need to learn from other people's elder brothers and get tattoos on your body.

Many people like the green dragon on the left and the white tiger on the right, and think that they are mighty and domineering, which is a child's idea.

She is really powerful, dressed in a gentle manner, and can control other people's life and death in the palm of her hand.

Without strength, it is useless from head tattoos to feet.

It will serve no purpose other than to keep people at arm's length.

[You have successfully transplanted skin, suturing +1, square knot +1, and health +1000. 】

As soon as he repaired the patient's wounds, Li Jingsheng earned his second huge amount of 1000 health points in history.

This makes him happy.

After the skin grafting, it cannot be considered as the end of the matter.

There is also a more difficult operation, which needs to be packed with iodoform gauze on the surface of the wound.

This is another technical job.

He gained a thousand health points, plus the 1672 health points he deliberately saved in the past few days, it was enough to upgrade the doctor level.

In order to prevent long nights and dreams, he did not hesitate and spent 2291 health points on the spot to directly upgrade the doctor's level to deputy chief physician.

After the upgrade was completed, he actually felt dizzy.

This is something that has never happened before.

He secretly screamed in his heart that it was terrible. If he had known earlier, he should have waited until the operation was over before upgrading.

Fortunately, this dizziness did not last long.

After the upgrade, he was pleasantly surprised to find that his medical clinical thinking, including understanding and comprehension of pathology, medical theory, and pharmacology, had been greatly improved.

This feeling is like suddenly changing from a poor student to an excellent student.

Before the upgrade, he felt that the attending level was already very good.

Only now do I understand that a mountain is really higher than a mountain.

Along with this, his understanding of surgery, as well as specific surgical plans, as well as surgical prognosis and risks, have been greatly improved.

When he looked at the patient's oral wound, he could even foresee what it would look like after surgery.

What are the risks in the first three to seven days after surgery?

There are also some details that can be seen or predicted in advance.

For example, the parotid duct is damaged during suturing.

Or skin graft necrosis.

If the skin graft is too thick, or the wound is not completely hemostasis before transplantation, it may lead to skin graft necrosis.

The skin is too thin.

After healing, the contraction is large, which can make it difficult for patients to open their mouths.

Taking the skin slice from the inner side of the upper arm, which is moderately thick, can be regarded as an accidental avoidance of these risks.

"It turns out that this is the strength of the deputy chief physician. It is really too strong. Even if the surgical ability is weak, the diagnosis and understanding of pathology and pharmacology are not comparable to the attending physician."

After Li Jingsheng felt the power of the deputy director, he was very satisfied.

The experience point requirement for being promoted to deputy director is 5000, which is a terrifying value.

Under normal circumstances, being promoted to deputy chief physician at the age of 38 is quite impressive.

Moreover, although many young deputy chief physicians have been promoted, their actual level is still far below.

Li Jingsheng is not even 30 years old now, and he already has the level of a real deputy director.

The Second Hospital offered a series of favorable conditions to recruit him, and they were interested in his bone-setting skills.

I want to make the bone setting business more stable and bigger.

Now that Li Jingsheng has the level of deputy director, he is afraid that he will be able to give Director Hua, Dean Fu and others a big surprise soon.

In this city's skills competition, he will shine even more if given the chance.

It is possible to become famous in one fell swoop.

He packed and sewed iodoform gauze on the patient's wound, and the operation was considered a complete success.

He even got 100 points of life for just hitting the gauze bag.

For almost every first operation, it is easy to get high health rewards.

Of course, the coolest thing is to collect the pennant.

Now he has a separate outpatient room in the Second Hospital, and he often receives pennants from patients.

Most patients still know how to be grateful.

People are not plants, so how can they not feel the kindness of doctors to them?

"You need to eat liquid food for seven days after the operation. During this period, you can't eat anything."

After hearing this, the patient became anxious for a while.

Wanting to speak, Li Jingsheng signaled him not to worry.

"I've come to the clinic for infusions every day these days, and I'll give you nutritional injections."

Li Jingsheng's offer of two thousand was really low.

The patient's lesions must also be sent for pathological biopsy!
Coupled with skin transplantation, three thousand is not too expensive.

Forget it, let's make less money from this business.The skin graft earned him 1000 life points, which was not a loss.

The patient's family background is very poor, and his mother can't even raise 2000 yuan, so she just does some charity.

Li Jingsheng took the patient out of the operating room, and explained the precautions to the family members again.

It seems that it is just a small operation. If it is done in a larger hospital, it is normal to spend seven to eight thousand.

The inspection fees alone cost a lot of money.

It only costs [-] here and it's all covered, which is definitely a huge profit.

Now I hope the grafted skin can survive.

Li Jingsheng will not be in the clinic for the next three days, and Dr. Shao and Tang Ping must take good care of him when the time comes.

Closely monitor the patient's condition.

He prescribed medicine to the patient, firstly prescribing today's medicine.

The main thing is to use antibiotics to control the infection, and nutrient solutions.

He is confident in his suturing, as long as there are no accidents, he should be able to eat liquid food in about five days.

(End of this chapter)