Gou in the operating room to add some upgrades

Chapter 22: Follow the danger of hospitalization (please collect and read)

Fang Xian didn't know until the disinfection and draping was completed, all the instruments were opened, and everyone took their positions.

Among the five people who just came in, there are two doctors, three nurses, and one anesthesiologist, whose exact ages are unclear.A clinician, I don't know which department he came from, but he came to the stage as an assistant anyway.

Three nurses, one instrument, one in addition to the standard circulatory equipment, and another one who didn't know whether it was an instrument nurse or a circulatory nurse helped open the table and left.

At the beginning of the operation, Wang Chuntao arrived at the chief surgeon position, Fang Xian was the first assistant, and the newcomer was a girl, who was the second assistant.

A disposable surgical cap covered her hair and bangs, a mask covered her entire face, and sterile surgical gowns and hand washing clothes covered her figure, leaving only a gap to expose her eyes and eyebrows.

Her eyebrows are very dense, self-curving, not thick.Peach Blossom Eyes, very serious at the moment, staring at the surgeon meticulously.

Fang Xian only had time to look at her like this, and followed her eyes to see the patient with a glove injury after washing.

The degloving injury on the sole of the right foot, on the surface, it should be "kissed" by the wheel.

"Xiyin, what's the general condition of this patient?" Wang Chuntao asked after starting the operation.

Only then did Fang Xian focus his attention on the girl again. Is this the doctor in charge of the bed?
"The traffic accident resulted in degloving injury of the plantar soft tissue of the right foot and a fracture of the cuneiform bone. There was no obvious surgical contraindication in the preoperative examination. One hour after admission to the hospital, emergency surgery for limb salvage treatment was planned."

"The boss of our department took it in." Zhou Xiyin's voice was very waxy, especially when it was formal, she still had the feeling of a little girl's endorsement, but she was sure she didn't do it on purpose.

She speaks very fast. If it was intentional, then she would not be able to speak so smoothly. This is her original voice.

"This is Fang Xian, the newly licensed doctor in our Trauma Surgery Department is a year ahead of you." Wang Chuntao explained to Zhou Xiyin.

Zhou Xiyin's eyes flickered slightly, a little incredulous: "There is a senior named Fang Xian in the sixth school year?"

Wang Chuntao explained: "Dr. Fang Xian is not an eight-year graduate."

"Oh." Zhou Xiyin suddenly realized, his eyes returned to normal.

Fang Xian also felt a bit in his heart, this is a college bully.

Although the medical academic system has been reformed and medicine no longer pays attention to academic qualifications, there is an essential difference between the admission score line of the eight-year college entrance examination in each college and the five-year college.

Many students in the eight-year clinical medicine major at Xiangnan University have college entrance examination scores that allow them to enter some majors in northern Qing Dynasty.

Wang Chuntao did not explain more and devoted himself to the operation.And Zhou Xiyin also tried his best to cooperate.

Fang Xian can take on more operations in the first assistant position, but he can also observe the operations of this junior girl named Xiyin, and then finds out that this person's operation level is also very good.

At least she can clearly know which position Wang Chuntao will clean up in the next debridement with a high probability. This is because she has a relatively familiar understanding of the overall design process of debridement, and can also speculate on Wang Chuntao's debridement habits based on the superior physician's debridement habits. Debride the habit.

This is not a level that can be achieved by proficient level debridement!
A doctorate degree does not have an academic advantage when looking for a job, but people who can get a doctorate will not fake what they learn. Similarly, students who can stand out in the college entrance examination and study the eight-year program of clinical medicine at Shonan University will not One is a nerd who studies to death!
The focus and principle of treatment for patients with degloving injuries lies in debridement, grinding, and preservation of healthy and blood-supplied tissues, followed by suturing and preserving the degloving limbs.

The principles and key points sound simple, but they are quite difficult to operate.

After all, degloving wounds are different from ordinary trauma wounds, and are a kind of destructive injuries. Such wounds are second only to super crushing injuries. You must be sure to deal with such wounds. There is no specialized debridement and specialized wounds. The basic theory of trauma surgery at the fine level, I dare not touch it at all.

Otherwise the patient will be advised to have the leg amputated in most cases.

However, it is obvious that Wang Chuntao passed the medical association's first-level physician certification before the age of 30. His strength, when faced with such an injury, is not guilty at all.

And while doing it, there is still time to sit and explain——

"The whole point of debridement is..."

"The point of this operation is...the difficulty of this patient's operation is..."

This kind of targeted guidance is the first time Fang Xian has enjoyed this kind of treatment, and he feels that he has benefited a lot, but the 'Xi Yin' standing opposite seems to be no stranger to it.

Wang Chuntao's operation speed is not slow. In just over 40 minutes, he has already cleaned up all the necrotic tissue on the surface.The wound that was exposed in front of Fang Xian again seemed to be no longer the wound of a degloving wound, but just a wound of trauma.

The principle of treating wounds becomes hemostasis and suturing!
If it is classified according to the classification of diseases, the initial disease classification of degloving injuries is three types of diseases, while the wounds of ordinary trauma are the largest three types of diseases.

Now the trauma of this patient is at most a second-class disease.

Through his own operation, Wang Chuntao carried out a 'dimension reduction attack' on the patient's current disease classification!
Fang Xian had only heard of this in textbooks before.

Perhaps in the large operating room of trauma surgery, Professor Lin Jiemo has completed such a "dimension reduction strike" more than once!
But Fang Xian couldn't tell the difference, and he didn't have a deep understanding of those difficult techniques, so he wasn't as comfortable as this ordinary trauma.

When Wang Chuntao was about to continue walking, his exclusive phone for the general hospital rang.

The itinerant nurse was very sensible, and after connecting the phone, she held it to Wang Chuntao's ear.

There was only one sentence from the other party: "This is the emergency department. The patient with multiple traumas is currently in shock. Please ask for emergency consultation with trauma surgery."

"Okay! I'll be there in 10 minutes!" Wang Chuntao didn't say a single word of nonsense.

Step back immediately after speaking!

Back away and at the same time order: "Xi Yin, you assist Fang Xian to complete the next operation. The subsequent operation is not difficult. Follow the principles of hemostasis, suture, and pressure bandage, and there will be no problem."

"Upgrade antibiotics after surgery!"

Fang Xian was a little dazed at the moment, and looked at Wang Chuntao seriously, trying to figure out whether what he said was true or not, and he just handed over this operation to himself so easily?
But Wang Chuntao really left!

"Okay, Doctor Wang." Zhou Xiyin replied calmly, but his eyes were solemn, and there was a little bit of panic in his solemn eyes.

Wang Chuntao left resolutely, but the itinerant nurses and equipment nurses in the operating room did not panic at all. The anesthesiologist was still playing with his mobile phone, and just glanced at the anesthesia machine, looking very calm.

After Wang Chuntao left, Zhou Xiyin asked, "Senior Fang, are you used to operating in this direction or are you in the chief surgeon position?"

Zhou Xiyin was standing on Wang Chuntao's starting position, which belonged to the second aid position, and Fang Xian was standing on Wang Chuntao's previous opponent, which belonged to the first aid position.

The matter has been settled, Fang Xian can only stand up: "I can do it, let's see!"

If his debridement and suture skills are still at level 2, then Fang Xian is still a little panicked, but Fang Xian knows his own strength, so he doesn't panic, but regrets why he didn't add all the skill points to Debridement, to be less flustered.

Being a doctor is a profession that requires a lot of accumulation.

Zhou Xiyin stood opposite Fang Xian, and at the same time, Zhou Xiyin handed the hemostatic electrocoagulation knife that Wang Chuntao was holding to Fang Xian, and then carefully searched for the blood vessels on the wound with tweezers and suction for Fang Xian's operation.

This is the case with debridement, first find the bleeding, and then slowly stop the bleeding.

The purpose of finding bleeding is to ensure the existence of blood supply at the soft tissue level, and the purpose of hemostasis is to avoid subcutaneous hematoma after suturing, which will affect the local blood supply of the wound.

Soon, Zhou Xiyin found the first bleeding point with tweezers and a suction device. She used the two ends of the tweezers to spread the bleeding point, and the suction device sucked away the superficial bleeding.

Fang Xian reached over and clicked, but it seemed that the time was too short, so the blood still oozes.

Fang Xian clicked again, and it was a little bit burnt, the electrocoagulation took too long to stop the bleeding.

Zhou Xiyin raised his head slowly, and suggested: "Senior Fang seldom performs hemostasis operations? How about we change it?"

Fang Xian's operation on hemostasis is obviously pure innovation.It's not that it can't be done, but this level of hemostasis has indeed lowered the operating level of the Hospital Affiliated to Shonan University.

"Okay!" Fang Xian decisively handed over the electrocoagulation knife, and then took the tweezers and suction device from her hand.

And Fang Xian, who took over these two things, seemed to have found his home field——

The specialized level of debridement allows him to easily find the bleeding point, and find some hidden foreign objects in the messy wound, which even Wang Chuntao didn't find before.

Debridement is the removal of foreign bodies and dead tissue.

Zhou Xiyin hurriedly helped with electrocoagulation to stop the bleeding, and said in a low voice, "My level of debridement is not as good as yours, but electrocoagulation is slightly different from traditional silk thread ligation to stop bleeding."

"Electrocoagulation is the use of high-frequency current heat to coagulate blood vessels!"

"Yeah." Fang Xian nodded. He really didn't have many opportunities to practice this. He usually just watched the superior doctor's smooth operation during the process of electrocoagulation to stop bleeding.

When I was doing the incision, the wound surface was relatively flat, and the main purpose of using the electrocoagulation knife was to incision. A small amount of bleeding was electrocoagulated to stop the bleeding, and the wound surface was normalized, which was much easier to operate than the wound surface of the degloving injury.

Every operation has its details and inner meaning!
Therefore, Fang Xian didn't feel embarrassed either!
After Zhou Xiyin completed the operation to stop the bleeding, Fang Xian once again found three foreign objects, a stone and two pieces of rubber. Zhou Xiyin finally couldn't help but ask, "Senior? How should we find these foreign objects in the wound?" "

When Fang Xian heard this, he felt an inexplicable sense of long absence.

Seniors, seniors, juniors, etc. are all words that I only heard during college. Since entering the clinic, Fang Xian has heard and called more and more titles such as senior brother, senior sister, senior sister, etc. in the past year.

Fang Xian was very honest, pursing his lips: "I don't know, I just found it based on my feelings and experience, and I can't tell you how to analyze it."

It's not that Fang Xian doesn't know how to teach, but that he himself has not yet reached the level of teaching.And the principles he knows have been announced by the Medical Association. A top student like Zhou Xiyin doesn't need Fang Xian to recite the assessment criteria for level 3 debridement for her.

"My hemostasis is the same," Zhou Xiyin explained.

The two and a half little rookies pecked each other in a circle, Fang Xian smiled: "Rinse it again and sew it up..."

(End of this chapter)