Gou in the operating room to add some upgrades

Chapter 226 Do you call this lack of experience?
When it comes to treating diseases, the applicability of basic medical skills is definitely not strong.

But when it comes to saving lives in emergencies, no matter how fancy professional skills are, they are not as practical as basic medical skills.

When the Medical Association carefully sets up basic skills, it is only for reference in saving lives.

Fang Xian, who has experienced many large-scale injuries and severe beatings, has basically no difficulty in operating this small intrapelvic hematoma and retroperitoneal hematoma.

This just requires stopping the bleeding.

Such diseases could be defined as level four diseases as early as 20 years ago, but now, they can only be classified as level three at most.

In only about 15 minutes, Fang Xian completed the hemostasis technique. After carefully checking that there was no more bleeding in the surgical field, Fang Xian silently returned the opportunity to perform the operation in order to save his uncle's face.

His life has been saved. Let Qiu Chengyuan complete the remaining hematoma removal surgery. After all, he has entered the workplace. Now he is an official doctor instead of a medical student. He still needs to know a little bit about the necessary worldliness.

Anyway, when it comes to suturing at the end of an operation, who is suturing is not suturing, and who is debriding is not debridement?

Qiu Chengyuan looked at Fang Xian for a while, then asked, "Has Xiao Fang been in the trauma center?"

Director Qin was dumbfounded all the way, his head completely shut down.

At this time, he finally found an opportunity to speak. He quickly asked: "Director Qiu, is the trauma center of the Shonan University Hospital really so powerful?"

Fang Xian's hard skills must have come from here.

It is difficult for associate professors of the hospital to enter the trauma center of the Affiliated Hospital of Xiangnan University. People like Qiu Chengyuan and Director Qin basically have no chance of entering.

The trauma center is not open to outsiders. In addition to well-known colleagues, the only people who can visit the center are the students of this hospital, to improve their morale.

Qiu Chengyuan was suddenly discouraged and turned around and said, "I don't know, it's too high-end. I wanted to go in back then, but I walked around the door and was kicked out."

"Fang Xian has been there, you can ask him."

Qiu Chengyuan took the opportunity to take over the operation, and then began to perform basic orthopedic skills such as hematoma removal. The operation was indeed not difficult. After the bleeding was completed, it was basically a procedural operation.

Fang Xian narrowed his eyes and replied: "Uncle Qiu, it's actually not that mysterious. It's just a gathering place for consultations by some professors. It may be an evolved version of multi-disciplinary collaboration."

Are trauma centers mysterious?
Fang Xian didn't feel too much, but the trauma center's network and appeal were really strong. It could almost gather the best professors in the hospital in a short time. How could the cohesion and strength not be strong?
But if you want to snatch people from the gate of hell and snatch lives from the hands of the king of hell, it cannot be justified if it is not mysterious.

Qiu Chengyuan felt a little guilty at the moment and joked: "You should call me Director Qiu. Being your junior uncle feels a bit stressful."

Although Qiu Chengyuan has the title of chief physician, his real ability is actually only a level 3 doctor. He has only one level 4 skill. And this level 4 skill is enough for him to fly like a dragon and a horse in Zhang Municipal People's Hospital.

But now, Qiu Chengyuan can only coil up like a dragon, and can only nest like a tiger.

"Uncle Qiu is joking, uncle is just uncle." Fang Xian replied.

Just as he was saying this, a person hurriedly approached outside the operating room, then quickly leaned into Director Tan's ear and whispered a few words.

After hearing this, Director Qin's face and eyes changed slightly, and he asked in a low voice: "Director Qiu, there is a patient with severe injuries in the operating room next door to us. His femur was comminutedly fractured and there was a bone defect. Now Director Huang has no idea what to do. deal with."

"You also know that diseases such as bone defects are relatively difficult to operate. This is another emergency surgery."

"If you want to save your limbs, it's better to rebuild them in the first phase, Director Qiu..."

Qiu Chengyuan's eyes jumped when he heard this: "Director Tan, didn't a big hand come to your hospital?"

"For difficult surgeries, you must first ask Dr. Fang!~"

Qiu Chengyuan knew what Director Qin was worried about, but Qiu Chengyuan knew that Fang Xian was like a dragon crossing the river when he came to the countryside to support him. If he wanted to climb up in the future, he would probably have to beg Fang Xian.

Now it is natural to give Fang Xian more face. With Fang Xian's current achievements, he will become a professor and director in the future, which is just around the corner.

He is only in his 20s, but he is already an attending physician, and his basic skills are still quite high.

Director Qin then spoke in detail again.

"Doctor Fang, look, if we go over and take a look first, there shouldn't be any big problems with the surgery here." Director Tan said with a smile.

Fang Xian hesitated slightly: "Director Qin, in fact, I only have some understanding of fracture treatment and have no experience."

"It doesn't matter, Doctor Fang, you must be good at theory, just give me some pointers." Director Tan understood Qiu Chengyuan's meaning and insisted on letting Fang Xian go over and take a look first.

If it doesn't work, just let Qiu Chengyuan here go over and complete the subsequent surgery.

……

Fang Xian couldn't refuse anymore, so he took off the sterile surgical gown and stepped off the stage, taking a glance at the patient's current vital signs.

The anesthesiologist responded proactively: "Don't worry, Dr. Fang, I'm watching over here."

Fang Xian slightly cupped his hands and said, "Thank you for your hard work, teacher."

Fang Xian's word "teacher" made the anesthetist feel an inexplicable feeling of relief. In this place where doctors are called "Lao Du Lao Tang", it is rare for people to call him "teacher".

"Yes, Doctor Fang, you can call me Tang Boshi. Literary Shi."

"It's not Dr. Tang." Tang Boshi introduced proactively to avoid being misunderstood. He must have been misunderstood many times.

Fang Xian followed the doctor who came to report the news to the other operating room where Director Huang was.

Director Huang only brought one person to perform surgery on the stage at this moment. After all, compared with the pelvic hematoma, the damage to the thigh was a bit too small.

Injuries to the thigh, or even amputation at worst, are injuries that do not involve life, but only involve disability, so they are defined as third-level diseases.

"Director Huang, Dr. Fang is here and said he would go on stage to take a look first."

Director Huang was stunned when he heard this. He looked at Fang Xian, who had washed his hands and put on sterile surgical gown. He didn't know what to say for a moment.

Li Zixiong was obviously asked to invite Director Qiu Chengyuan. Why did you invite the gold-plated Dr. Fang to have everyone stare at each other on the operating table?

However, he is a guest from afar, and Fang Xian is coming to the countryside to support him, so he still has to give him the necessary face.

Director Huang smiled slightly and said, "Thank you for your hard work, Doctor Fang."

"Director Huang, let's take a look together." Fang Xian was already wearing sterile gloves and asked the circulating nurse to help him tie his back tie.

After putting on the gloves, he untied the bow of the sterile surgical gown in front of his abdomen, handed it to the instrument nurse, and turned it around.

Tie the knot close to the operating table.

Just by raising his toes and taking a look, he instantly understood a little bit about the patient's condition.It was a damage to the middle part of the thigh, skin degloving, muscle necrosis and debridement. After debridement, the middle part of the femur was comminuted and defective. Now we are considering whether to directly reconstruct the femur in one stage, or to directly use an external fixator and ignore the defective part. .

One-stage surgery means that the corresponding operations are completed in the first operation.

Second-stage surgery involves specifically completing certain operations for the second time.

The treatment of bone defects is a difficult point in orthopedic treatment. The most difficult bone defect is the reconstruction of pelvic defects, which will make the patient unable to sit down on half of his buttocks.

Secondly, there are defects caused by fractures of limbs.

But don’t think that this disease is life-threatening, it’s quite easy!

Although thigh damage is a third-level disease, it has a low mortality rate and only requires amputation.

As for bone defect, because of its extremely high difficulty in operation and treatment, it is a real Level [-] disease. It is a Level [-] disease that does not rely on mortality.

Only the directors of prefecture-level hospitals can covet its treatment. The average deputy chief physician would not even dare to touch it. Even at the Affiliated Hospital of Xiangnan University, Professor Lin Jiemo may not dare to say that he We can ensure that the surgical quality of every operation is absolutely high.

"What's the approximate length of the defect?" Fang Xian asked after scanning and measuring it.

Fang Xian has done all the reconstruction of pelvic defects. Although his proficiency in bone defect reconstruction is only level 3, he may not be able to perform it in the operating room of Shonan University Affiliated Hospital or even the trauma center.

But with level 3 proficiency, it is not difficult to complete this operation, and the recovery after the operation will definitely not be bad.

Moreover, Fang Xian only has level 3 proficiency, so he can still add some.

3级到4级是500，4级到5级只要5000.5500点技能点，对于如今身负二10,000+技能点的方闲而言，还是一点都不多的。

"Six centimeters." Director Huang replied solemnly.

Six centimeters is not too short.

If a leg is six centimeters shorter, it is almost the same as being lame and must be made up.

But what is missing is what is missing and must be made up.

This also requires pedicled bone transplantation, which is another operation method and one of the operations of hand surgery. It has a certain level of overlap with trauma surgery and is also a very difficult operation method.

In terms of operation difficulty, it is also defined as a level four operation. Only associate professors of hand surgery can perform it routinely. It is also extremely difficult for ordinary surgeons to perform a pedicled bone flap.

"Have you discussed issues related to bone transplantation and bone grafting materials with the patient's family?" Fang Xian asked again.

"The patient who caused the accident has medical insurance, so the cost is not a problem. It's not much." After Director Huang replied, he said, "Dr. Fang, this is a bone transplant."

"Director Huang is the deputy chief physician. He is performing this operation. Doesn't it count as a leapfrog?" Fang Xian is now almost psychologically affected by the word "leapfrog surgery", so he had better ask clearly first.

To avoid any further setbacks.

In fact, speaking of it, the reason why Fang Xian got into trouble during the last operation was because Fang Xian performed the entire operation by himself, and there was no higher-level doctor to take charge.

Wang Yang is the chief physician, but he is not a reliable superior.

In fact, according to the regulations of the Medical Association, Fang Xian has the authority to sign the surgery, and he is qualified to perform the surgery. However, this clause is not written into the Physician Law, but is only a rule recognized within the medical community.

This is the end of the calf.

In medicine, it is not possible even if the law prohibits it, but it is impossible even if the law does not allow it!
"It doesn't count," Director Huang replied.

"That's fine." Fang Xian nodded.In my mind, I directly increased the two operations of pedicled craniectomy and bone grafting to level 5.

This is the greatest comfort that Fang Xian can achieve in his heart. He is worthy of his patients and worthy of his own limits.

Perfect operation does not have this ability now, and Ruyi-level skills are the best technical guarantee that Fang Xian can provide.

As soon as Fang Xian responded, he approached the operating table and continued to inquire: "Director Huang, how about I give it a try?"

Director Huang thought for a while and decided to give Fang Xian this face.

Only after Director Huang allowed it, Fang Xian began to operate.

The first choice for removing a pedicled bone flap is the fibula, which is not particularly load-bearing in the lower limbs, and is the fibula on the affected side to avoid having to perform multiple incisions, which may affect the function of the healthy side.

As for the fibula, in the treatment of osteoarthritis, there is a method called fibular osteotomy, which is to cut off the fibula to slow down the progression of arthritis.

After successfully adding points, Fang Xian immediately performed the level 5 debridement technique and scanned the wound again. Instantly, it became cleaner and fresher, and the surgical field became clearer.

Inside look at the doorway.

With this basic operation, Director Huang and another assistant knew that Fang Xian had a skill in his hand.

The following incision is made to find the fibular nutrient artery, and the nutrient artery is taken to make a pedicled bone flap and osteotomy...

The whole process, with the full firepower of Ruyi level skills, is naturally as smooth as a cloud.

Ka Ka Ka Ka Ka Ka!
Director Huang and another assistant, who were completely unprepared, were dazzled by what they saw and couldn't close their legs.

Even looking back, after seeing Fang Xian's operation becoming more and more smooth, Director Huang even said: "Doctor Fang, here? Why do you do this?"

Fang Xian raised his head and glanced at Director Huang, and then said: "Director Huang, these are surgical reviews. We will find time to polish them after the surgery is completed. This is a basic issue in the surgical operation process."

Good guy, this Director Huang doesn't even understand the most basic process, and he still wants to ask questions. Fang Xian finally understood why when he was a student, his superiors told him not to ask stupid questions whose answers could be found in books. What a waste of his time.

Fang Xian's answer was very polite.

Director Huang said no more.

Fang Xian continued to operate.

It just so happened that Qiu Chengyuan and Director Tan had already completed the intercourse and came over to see the situation. Their plan was to help if they needed help. If they didn't, they would wait until they stepped down and have a midnight snack together.

When entering, Qiu Chengyuan said to Director Qin: "Director Qin, Dr. Fang, maybe he only worked in the trauma center before, so he is best at basic medical operations related to life-saving, and he does not have a deep understanding of specialist procedures."

"But it can definitely be fast."

Qiu Chengyuan approached the operating table as he explained, then his voice suddenly stiffened, he raised his head and looked at Fang Xian in astonishment.

The corners of his mouth under the mask suddenly twitched and twisted: "Dr. Fang, do you call this inexperience?"

(End of this chapter)