Dr. Chung’s 90s

There was an anesthesiologist in the emergency room, and Chu Jianwen was fine for the time being, so he simply went along to watch the fun.

Dean Luo strode in front, followed closely by Zhong Yu and Chu Jianwen. Chu Jianwen had a slumped face and looked like he was still angry. He kept complaining in a low voice as he walked:

"This man is really brave. Even if he is at the same level as you, he is not as senior as you in the hospital. He obviously came to see you in the emergency room, but he actually took it upon himself to rob someone. It's really funny."

Zhong Yu didn't think deeply about this matter. It was possible that Director Du didn't understand the ways of the world. She had to take another look.

He turned his head and warned in a low voice: "Don't make things difficult for Dean Luo. Director Du is older and I should respect him more. Maybe he just handles things this way. Don't be malicious."

Chu Jianwen was not stupid. Although he was not happy, he still closed his mouth and watched what happened.

When they arrived at the emergency room, Director Du was debriding the patient. Zhong Yu got closer and saw that the patient was a young woman in her twenties or seventies.

Her hands and wrists were burned by fire, and the wound area was somewhat large, with bones and tendons exposed in large areas. This situation cannot be repaired by simple autologous skin grafting.

Du Jin's face was serious. Judging from his skillful debridement techniques, he had indeed not spoken nonsense before.

Due to the thin skin and soft tissue of the wrist, chemical burns, fire burns, thermal pressure injuries, etc. are often more seriously injured, with exposed tendons and bones.

Thorough debridement of the wound is the key to reducing the occurrence of infection. For patients with serious contamination and whose activity of deeply damaged tissue is temporarily unclear, continuous negative pressure closed drainage is required after the first stage of debridement until the infection is controlled and the tissue boundaries are clear. Reconstruction.

Du Jin's operation method made the originally gloomy-looking Director Luo calm down a little. After more than two hours of observation, when Director Du was about to insert the drainage tube, he turned his head and asked Zhong Yu in a low voice:

"Is Director Du's handling of the matter appropriate? Are there any shortcomings?"

Zhong Yu frowned slightly and said honestly: "Director Du's treatment method is correct, but I suspect that unknown chemical substances have infiltrated into the patient's wound. It should be rinsed several times more and the ingredients need to be analyzed if necessary, otherwise there will be postoperative infection. risks of."

She did not deliberately lower her voice when she said this. Regardless of the relationship between the two, the patient should not be allowed to take risks.

Du Jin did not take Zhong Yu's words to heart. The patient was already in shock. He continued to insert the drainage tube calmly. He ignored Zhong Yu and said to Dean Luo confidently:

"Don't worry, Director. Based on my experience, the patient only has an ordinary burn. It is enough to rinse the wound with normal saline two or three times, and the drainage material can be removed for surgery in about five days."

Zhong Yu's ability is obvious to all, and Dean Luo is essentially more inclined to her. However, Du Jin's past performance is indeed good, and it is really unjustifiable to rashly interfere with his diagnosis and treatment.

In any case, the patient would not die from this, so Dean Luo did not force anything. He glanced at Zhong Yu, and Zhong Yu immediately understood what he meant, and subconsciously took a step back without saying anything more.

Dean Luo said sternly: "Since the patient is in your hands, we have no problem with it if you think it is. If you are responsible for the subsequent surgical treatment, you will have to tell me about the surgical plan later."

Dean Luo has a cautious personality. His criteria for hiring people are mainly based on clinical performance and patient recovery. He doesn't believe anything else that is said.

After the patient's debridement was completed, Zhong Yu came out of the emergency room and was about to leave with Chu Jianwen when Dean Luo stopped her.

"Director Zhong will leave in a moment. Let's listen to Director Du's surgical plan with me."

Zhong Yu's eyes flashed. Dean couldn't trust Du Jin. She didn't think Du Jin would listen to her opinion, but Dean Luo always had to give her face.

Chu Jianwen wisely left first. She finally understood that Zhong Yu could not suffer any loss.

The two of them waited outside the emergency room for a while. Du Jin still looked confident when he came out. Although he didn't like Zhong Yu very much, he still respected Dean Luo and followed him to the office with a decent attitude.

After entering the office, Dean Luo got straight to the point:

"Let's not waste any more time. Director Du, tell me about your surgical plan. Director Zhong and I will listen to it, and you two can learn from each other."

Du Jin smiled and said quite proudly:

"Director Zhong is young and should really listen and learn more. I plan to use artificial dermis combined with autologous blade-thickness skin transplantation for the surgery. Director Zhong may have heard of it, but he has definitely never used it. You can learn more from me. It will be of great benefit to you." benefit."

Zhong Yu said calmly: "If Director Du doesn't mind, you can talk about it."

Dean Luo was slightly dissatisfied with Du Jin's contempt for Zhong Yu, but he did not stop him and allowed him to continue speaking.

Du Jin said enthusiastically: "Artificial dermis is not widely used yet, but it is a double-layered biological material with a polyester fiber membrane as the upper layer, which can protect the wound surface, prevent the wound surface from evaporating, maintain the integrity of the underlying structure, and prevent infection. , and it has a certain mechanical strength, and its basic shape can be maintained 2 to 3 weeks after surgery.

At the same time, due to its good breathability, moisture permeability, tensile strength, softness and other properties, it has good adhesion to the wound surface and can create a good environment for cell growth and reproduction. "

Zhong Yu nodded expressionlessly, indicating for him to continue. Du Jin smiled and said:

"The lower layer of the artificial dermis is endless porcine collagen, which has extremely low antigenicity, wide sources, low price, and strong economy. At the same time, as a collagen sponge layer, it is conducive to the growth of capillaries and Fb to form a dermal-like tissue, replacing Defect of dermis.

When vascularization is completed, a good basal layer can be formed, which is conducive to the second-stage autologous split-thickness skin transplantation. The autologous split-thickness skin transplantation combined with artificial dermis has more application value and can achieve an effect close to full-thickness skin grafting, which is beneficial to skin donors. It has obvious advantages in reducing scar formation in the recipient area and donor area. "

After speaking, he paused deliberately, and then said with a sense of superiority: "Director Zhong also knows that I come from the Capital Union and I am at the forefront of various surgical treatments. It's normal that you don't understand."

Zhong Yu raised her brows slightly but did not get angry. She commented calmly:

"Although there are reports that artificial dermis combined with blade-thickness skin graft repair has achieved good clinical results, has Director Du forgotten that it also has shortcomings such as poor wear resistance and prone to repeated ulceration in the later stage?"

Her eyes were sharp, like an unsheathed sword, which made people unable to resist. Du Jin's face froze, and he looked at Zhong Yu with some surprise. After all, these internal information had not been disclosed yet, and he didn't understand how Zhong Yu knew about it.

He said a little aggressively: "Since Director Zhong doesn't agree with my surgical plan, I think you have a better one, so you might as well tell me about it." Zhong Yu chuckled lightly, "Director Du, I'm the surgeon. A modified pedicled chest and umbilical flap is used to repair deep burn wounds on the hands. Although the traditional pedicled chest and umbilical flap has the advantages of simple operation, high survival rate, and low surgical risk when repairing the patient's wound, there are also treatment problems. Disadvantages include long time and high medical expenses.

The improved surgical method takes into account the precision of wound repair and the minimization of donor site damage, which can ensure the patient's functional recovery to a large extent in terms of blood supply. The Doppler blood vessel detector is used to identify the paraumbilical perforator of the inferior epigastric artery before surgery. It is a blood supply system, making the skin flap less susceptible to tension and other effects and causing circulatory disorders. At the same time, the skin flap has rich blood supply and strong anti-infection ability, which can reduce the occurrence of basal tendon or bone infection, and is very suitable for tendons and bones in the hand. Repair of exposed wounds. "

What she said was reasonable and well-founded, and Dean Luo quite agreed. She glanced at Du Jin again and said lightly:

"From an aesthetic perspective, due to the rich subcutaneous fat tissue in the chest and abdomen, the traditional pedicled thoracoumbilical flap will cause the flap to become bloated after surgery. The patient needs to undergo flap thinning surgery again, and the donor flap area is prone to scarring, which affects Beautiful.

The improved surgical method can avoid blood vessels under a magnifying glass or microscope, trim and remove some fat particles, and thin the skin flap, which will help reduce skin flap swelling and improve the flexibility of the wrist after surgery.

At the same time, due to the low tension in the donor area, it can be directly pulled together and sutured. Some wounds that are difficult to suture can be repaired by adjacent skin flap transfer or autologous skin grafting, which solves the aesthetic problem well. "

Zhong Yu's surgical plan was comprehensive and could suppress Du Jin's arrogance without any actual operation.

Du Jin was panicking and regretted his previous words and deeds. He didn't even dare to look at Dean Luo's face.

Dean Luo acted tactfully and said in a sincere tone:

"Both doctors are rare talents in our hospital. Only by discussing with each other can we create different sparks. You are both very good, but the patient is a young woman after all. Considering her actual condition, I think it is Director Zhong's surgery. Which plan is more suitable, or else Director Du will adopt her plan?"

Du Jin looked confused: "Director Zhong's surgical plan requires avoiding blood vessels under a magnifying glass or microscope. The precision required here is too high. My hands can no longer perform such fine movements..."

He looked a little sad. He switched jobs from Xiehe, which may not be without this reason.

Dean Luo is also a good person, and he immediately understood the key. Although he can't do precise operations, ordinary diseases can still be solved. After all, he has rich clinical experience, which has been accumulated through hard work, and he is not included in it. Made a loss-making transaction.

Although Dean Luo was disappointed, he managed his expression very well. He pondered for a moment and said:

"After all, he is a young soldier, so the beauty of his hands is still very important. Otherwise, this surgery should be left to Director Zhong. Director Du can assist if he is willing."

The patient is not a guinea pig. If there is a better surgical plan, why not use it? Who will bear the blame and infamy if ulceration and infection occur later?

Du Jin was unhappy in his heart, but he didn't dare to have the slightest objection on his face. Who said that his skills were inferior to others.

He wisely said: "Director Zhong has his own surgical team, so I won't get involved in it. Just let the two young people on my side follow suit during the surgery."

Dean Luo agreed. After all, his problem was not with learning. He could not do fine operations with his hands, and no matter how much he knew, it would be of no use.

Dean Luo looked at Zhong Yu again and said gently: "Let Director Du hand over the medical records to you later, and you can arrange the follow-up surgery."

Zhong Yu nodded in a neither humble nor condescending manner. She had no objections to Dean Luo and was willing to cooperate with his work.

"Don't worry, Dean, I will restore the patient to his best condition."

Dean Luo felt completely safe leaving the patient in her hands. He smiled and said:

"Then you go and do your work first. I'll have a few words with Director Du."

Since Du Jin didn't have the strength to dominate the world, he had to curb his bad temper. Dean Luo had to give him a beating. Zhong Yu was not suitable to listen, so she said goodbye with a smile and left.

As soon as she walked out of the office, she saw Du Chuanshan waiting at the corner of the stairs. When he saw Zhong Yu, he immediately stepped forward and explained:

"Teacher Zhong, I apologize to you on behalf of my second uncle. He is not a bad person, but he is not very good at dealing with interpersonal relationships. Although his words are not nice, his heart is not bad."

Zhong Yu glanced at him indifferently and said in a normal tone:

"Doctor Du, I have no conflict with Director Du and I don't need you to apologize. Although you are in the internship period, our identities are equal. You can just call me Director Zhong. I am not your teacher."

After saying that, she walked towards the stairs without any intention of continuing to communicate with him. Du Chuanshan quickly followed her and said anxiously:

"Director Zhong, I really like you. I came here for internship because of you. Can you stop being so indifferent to me?"

Zhong Yu paused as he walked down the stairs and said with an unhappy face:

"Please don't associate me with you. From the first time I learned your name, I made it clear that I have a partner. Your internship is not for me. You have to do the internship even without me. This is your professional development requirement. , you are a student of the Military Medical University, so it is natural for you to come here for internship, so don’t just touch me."

Du Chuanshan was shocked by her sharp eyes and stood there for a moment. Zhong Yu looked at him from top to bottom and said without mercy:

"Don't be as self-aware as your uncle. If you like me, do I have to respond? Who do you think you are? How much is your sincerity worth? Is it so easy for me to get it? Don't impress the rookie by yourself. When you have the time, take care of yourself. Go study.”

Her words were harsh and unpleasant, making Du Chuanshan's heart break.

In a sense, he was innocently shot. Who asked his uncle to make Zhong Yu unhappy? He took the initiative to do it himself. If not him, who would blame him?

Zhong Yu felt refreshed after venting her anger. She returned to the department, went to the outpatient clinic first, knocked on Zhou Ze's clinic door, and said in a relaxed tone:

"Take the time to observe the condition of the female patient with hand burns today, and then prepare medicines and materials related to the surgery."

Zhou Ze was stunned at first, then his face was full of surprise. He knew what happened before. The patient who was snatched away by Director Du was finally operated on by Director Zhong. This was really a slap in the face.

He said loudly: "Don't worry, Director Zhong, I'll do it right away."

He couldn't wait to share the good news with Zheng Jun and Chu Jianwen. If they had known that Director Zhong was pretending to be a pig and eating the tiger, they wouldn't have to worry so much.

Zhong Yu looked at his back and shook his head and laughed. She was very easy to get along with. If you respect me a foot, I will respect you a foot.

She won't give in if she has to fight her head-on. Who can do anything to her if strength is supreme?