Gou is practicing medicine in the clinic

Chapter 42 'Cold weapons' and feel
In terms of equipment, there are usually three commonly used separation equipment.

The first is all kinds of traditional scalpels.

It is a "cold weapon", but it has advantages that other instruments cannot match when it separates some extremely difficult tissues or organs, blood vessels, and nerves.

Many surgical experts call it a double-edged sword.

If you grasp it well, there will be various bonuses.If you don't grasp it well, medical accidents are beckoning ahead.

One of the benefits of practicing traditional scalpels that drives all surgeons crazy is feel.

Now there are all kinds of electric knife and laser knife, which are very convenient to use.

But the sense of technology is too strong.

If you want to practice sharp tactile feedback, only traditional scalpels can do it.

A powerful surgeon, once he cuts down, as long as the blade touches the tissue, he can immediately say it with incomparable accuracy with his eyes closed.There are even big surgeons holding a knife and pressing on the incision to know whether there are large blood vessels or nerves underneath.

This ability allows them to dance on the tip of the knife and perform all kinds of high-precision major operations without any disadvantages.

It's just too difficult to practice sharp tactile feedback.

Li Jingsheng couldn't afford an electric knife temporarily due to his limited conditions, not even the simplest and most commonly used monopolar electric knife.So the operation can only be performed with a traditional scalpel.

Now is an excellent opportunity to practice traditional scalpel separation of diseased tissue.

With proficient skin incision and superficial debridement as the basis, as long as he is careful, he should not overturn.

Quickly consider the gains and losses and risks in my mind.

Then take another deep breath and make a decision.

Try to separate this sinus tract for patients with the uninitiated sharp separation method.

Regardless of success or failure, his separation technology will be improved by leaps and bounds.

Actual combat is the fastest way to improve skills.

He never fought unprepared.

Begin to carefully recall many points of the traditional scalpel sharp separation method.

"Close blood vessels as much as possible before cutting!"

"The resected tissue should be fully exposed and identified to ensure that the cut tissue is under direct vision during the whole process of cutting to avoid wrong or overcutting."

"Tissue cuts using ligatures or hemostats should have stumps of sufficient length to avoid slippage of the ligature or hemostat."

……

Tang Ping did not urge him, but waited patiently for Li Jingsheng to carry out the next operation.

"Sister Tang, can you help me open the wound to both sides?"

"No problem. With a hook or just with your hands?"

"Use the flat hook! But be careful, make sure I have enough tension for the surgical field of view and the separation of the sinus tract."

Li Jingsheng really had no choice but to let her take on multiple jobs due to lack of manpower.

Pulling hooks is a manual task, and nurses are rarely called to do it.

They are all free interns or regular trainees, and they are called to help pull the hook.

Unless the resident doctor is a hook for the chief doctor's surgery, he will rush to do it.The attending physician's second-level surgery told them to pull the hook, how unwilling.

He wasn't even interested in even some more skilled residents who offered him a chance to sew his skin.

Because the technique of sewing leather has been practiced.

Under Li Jingsheng's guidance, Tang Ping opened the incision on the patient's back, and blood gushed out again.

However, Li Jingsheng acted very calmly. After clamping a piece of hemostatic cloth and drying it, he immediately devoted himself to separating the sinuses.

There are several reasons why he dared to do this.

First, the sinus tract is not deep and the risk factor is small.

Second, the sinus tract is very thin, and the area to be resected will not be large.

Third, I have a certain degree of confidence in myself, and I am eager to learn a separation medicine technique.

……

I saw him carefully slashing and pulling with the knife, gradually separating the left side of the sinus tract from the healthy tissue.Then work on the right side.

Every time before separating one side, he double-checked that there were no larger blood vessels.

If it breaks, as long as it is not a large artery, it can be rescued.

But then it got into trouble and the signboard was smashed.

So this time you need to take a big risk.

To be precise, there are many unknown risks for surgeons to perform any operation, even the simplest one.

After doing this job, if you are timid, go home as soon as possible to take care of your children.

In the words of the teacher with the teaching staff, one must be bold and careful in performing surgery, study hard and practice more.

1 minutes on stage, ten years off stage.

With his efforts to separate, Dou Dao gradually separated from the surrounding tissues.

Although the post-dissection incisions were uneven, overall it was an absolute feat to isolate a difficult sinus tract in a patient for the first time.

Of course, this matter must not let the old man know.

Otherwise, he would be so angry that his small clinic would be demolished directly.

A full 21 minutes passed, and the entire sinus tract was successfully separated and removed by him.Throwing it into the plate, the old man raised his neck vigorously and glanced at it.

"Doctor Li, is that what caused the pustules on my back?"

"That's right, it is the culprit of the long-lasting pustule. Now it has been successfully cut off. Don't move, I will clean the wound for you and suture it to stop the bleeding."

Li Jingsheng said to him.

He felt that he had gained a lot from successfully separating the sinus.

Both psychologically and technically, there have been leaps and bounds.

It's not the time to check the harvest of medical skills yet, and it won't be too late to check the changes in the attribute panel when the operation is finished and there is time.

He carefully debrided and trimmed the wound.

Then the original abscess cavity on the back was debrided and sorted out again.

The abscess cavity has been debrided several times and appears to be fine, with no new overt infection.So just clean it up again.

The part that connects with the sinus tract has been completely resected.

After finishing, Li Jingsheng seized the time to suture the wound caused by sinus resection for the patient.

If it was in the past, he must have sewed like a dog bit him.

And only entry-level continuous or interrupted sutures can be used.

At this moment, he has learned four sewing methods, and all of them are at the proficiency level.

He seemed confident in suturing this wound.

The newly learned horizontal mattress suture can not only reduce the tension of the wound, but also tighten the epidermal blood vessels to help the wound stop bleeding. It is perfect to use it.

The proficient horizontal mattress stitch works pretty well.

The stitching speed is at least twice as fast as the entry-level one.

In addition, his current knot-tying level has also improved. Square knots, surgical knots, and slip knots are all proficient.

That's a handy one!

Just two words, really cool.

After suturing the old man's wound, the surface was disinfected, and gauze was applied to protect the wound.

"Okay, I'll help you up. You can't go now, you will need an infusion later. Also, after you go home, you must protect the wound and keep it from getting wet. If it becomes infected and festers, it will be troublesome, and it may even threaten your life. .”

Now the surgery is done, and it's been done successfully.

Li Jingsheng also let out a long sigh of relief.

Give it a go, the bike turns into a motorcycle.

The successful completion of this challenging operation today is of great significance to him and Sunshine Clinic.

At the same time, it also helped the patient solve a big problem.

Surgery can be done, post-operative care is also very important.

In situations where patients cannot be hospitalized for management, there are many unpredictable risks.

For example, the patient refuses to listen to the persuasion, and when he returns home, he is happy and takes two sips of wine.

Or if the weather is hot, you want to take a bath, etc., all previous efforts may be wasted, and there will be extremely serious consequences.

Li Jingsheng had to make the consequences more serious, so that the patients would not dare to mess around.

"Don't get wet, I promise not to get wet. Even if my body smells like lice, I won't get wet. Is it okay to wash your face?"

When the old man heard that water on the wound could be fatal, his face changed with fright.

Quickly express your opinion, you must not get wet.

"Washing your face and washing your hands is not a big problem. But you must be careful not to let the wound get wet. Also, if the weather is hot, turn on the air conditioner at home to prevent your back from sweating."

Li Jingsheng helped the old man out of bed.

Did not dare to let go.

The patient is over 60 years old, just finished the operation, and has been lying down for so long.Stand up suddenly and fall easily.

Within the clinic, he must be responsible for the safety of the patients.

"Can't you even sweat?"

"Certainly not. Sweat is the most likely to breed all kinds of bacteria. When it gets on the wound, it will cause infection in all likelihood. When I was working in a big hospital, there was a patient who refused to be persuaded. In the end, our doctors and nurses rescued him together. I couldn't save him overnight."

Tang Ping spoke clearly.

I have been working with Li Jingsheng for a long time, and the two of them sing and harmonize with patients or customers, which is really excellent.

"Oh, it's so serious! Thank you for reminding me, I must pay attention."

The old man seems to cherish his life very much.

Think about it too, with a high retirement salary every month, it is a comfortable little life.

He must be reluctant to die.

"If you go out, it is not recommended for a while. If you get caught in the rain or are pushed by someone, the risk is very high. The sinus tract on your back has been cut off. If there is no accident, just cooperate with the treatment and pay attention to nutritional supplements , It may take less than half a month to recover."

Li Jingsheng also knew that if the old man stayed at home for a long time, he would definitely not be able to hold back.

Given a deadline of half a month, the old man thought about it and passed it.

"Sure, I've been staying at home watching TV recently, teasing my starling."

The old man happily made the choice that was best for him.

Opening the door of the treatment room, the old lady anxiously walked back and forth N times outside the door. When she saw the old man who was being helped out by Li Jingsheng, her eyes turned red.But after seeing that the person was fine, a happy smile appeared on his face immediately.

"Doctor Li, is the surgery done?"

"You wrapped such a big red envelope for me. If it didn't work out, I'd be so sorry for you! Now that the operation is over, the property will be returned to the original owner. You gave it to me, and now return it intact here you are."

Li Jingsheng's operation was successful, and he was in a good mood.

With a smile, he returned the stack of cash given by the old lady back intact.

When the old man saw the situation, he was taken aback for a moment, and then he understood everything.

He didn't say anything, just looked at the old lady, just like a boy in first love seeing his beloved girl.

As if stuck with glue.

Men's feelings are generally very deep and not good at expressing, but they like to express it with practical actions.

"Don't, don't, I'm willing to give this to you. Now that the operation is successful, I think the money is very worthwhile." The old lady glanced at the old man with a little guilt.

Probably because he was afraid that the old man would blame her for secretly giving Dr. Li a red envelope.

But when she saw the old man's bewildered eyes, she immediately felt confident, and it was even sweeter than eating honey.

(End of this chapter)