Come on, Dr. Wu

Chapter 114 Duan Ma feeds

Chapter 114 Duan Ma feeds
  You will definitely need to be sent to the EICU after the operation. The operation is only the first step. Don't think that the operation is over and the patient will be safe later.

Traumatic shock, traumatic coagulopathy, infection and other difficulties are still waiting for patients.

With an injury of this level, even after surgery, the whole body's immune system is almost at the point where it is on the verge of breaking defenses. Doctors have helped with the major hurdles, but infection, coagulation, and other minor hurdles can only be left to the patient. Too many drugs will have no effect if the patient's own foundation and willpower are not strong enough.

"Doctor, doctor, how are you? How is my wife? Is she okay?"

Seeing Wu Xiaofu and the others coming out, the patient's husband and other family members hurriedly rushed over. Although it was only the time for an operation, Wu Xiaofu looked at the patient's husband, and it seemed that his whole spirit had collapsed, as if all of a sudden He looks much older, which shows what kind of spiritual test and torture the patient has experienced in these short few hours.

"The operation has just been completed, the bleeding has stopped, and the condition is temporarily stable. However, there are still many tests that need to be experienced in the follow-up. Whether it can be overcome depends on the patient's subsequent recovery. In the next period of time, the patient will need Continue treatment in the intensive care unit, and the doctors there will contact you when the time comes."

call!
  The patient's husband immediately breathed a sigh of relief when he heard this. No matter what happens next, the operation was finally completed successfully. At least the doctor saved her chance of survival. As long as they don't abandon or give up, he believes that his wife will be able to survive. Wake up again.

Thinking of this, the patient's husband was even more grateful to Wu Xiaofu and the others.

"Thank you, thank you."

Operating room restaurant.

Wu Xiaofu sent the patient to the EICU and then returned to the operating room to prepare for the meal. He had been busy all morning, and now it was already one o'clock, and his stomach had already started to rebel.

The restaurant in the operating room is just a place to eat, but there is no kitchen for cooking. We order lunches from outside.

The food in the First Affiliated Hospital is much better than what Wu Xiaofu had when he was a graduate student.

"Xiao Fu, after dinner, come and do a hernia with me."

Ah!
  hernia!

Wu Xiaofu took a careful look at Lian Jingwei. Forget about the appendix and gallbladder, but also the hernia. Is the general surgery department really not in a hurry?
  However, Lian Jingwei's reaction surprised Wu Xiaofu. He was very calm and disapproving, obviously he was used to it.

Wu Xiaofu suddenly felt a bit proud. Being able to perform surgery is a symbol of whether a hospital's emergency department is powerful or not. Just like the emergency department of the First Affiliated Hospital, it can perform operations on appendix, gallbladder, hernia, and liver and spleen from the general surgery department. For surgeries such as rupture, you can also compete with the cardiology department for interventional treatment. This is already a symbol of a mature emergency department.

Surgery represents strength and money.

However, if you think about it carefully, other departments also wish that the emergency department could handle all the patients sent to the emergency department themselves. In this case, their duty would be much simpler. In fact, the ideal emergency department is really like this. After the emergency is resolved, , and then sent to the relevant departments. In this way, the pressure on the relevant departments can be greatly reduced and they can concentrate on their daily work.

Most hospitals now support emergency departments for this reason.

In the operating room, Wu Xiaofu looked at the operating drape. Is this one? Are there several? You know, hernias are basically elective operations. The general surgery department of the First Affiliated Hospital is really good-tempered to compete for patients like this. However, Duan Hao couldn't prepare all this for him, right? Wu Xiaofu thought, and became more and more certain in his heart. After all, hernia surgery is not a big deal, and it is incomparable to the gallbladder and appendix.

Generally speaking, attending doctors are not willing to do it, and they basically leave it to residents. The surgery is relatively simple, and there are almost no intraoperative risks. It is absolutely curable with practice. Residents in general surgery are basically trained with hernias. Not only technology, but also confidence.

"I'll make one first. With your understanding, you should be able to get started quickly."

Duan Hao said, and Wu Xiaofu immediately understood that he had guessed correctly, and he couldn't help but feel a little touched. Duan's mother who took the initiative to feed the surgery really made him have the urge to commit herself to her.

Wu Xiaofu will not look down on hernia. He also needs a lot of surgeries to better and more perfectly absorb the skills of another soul. Hernia is just right.

Duan Hao didn't do it fast, and Wu Xiaofu didn't ask stupidly or wonder why Duan Hao did it so slowly. This is a detailed explanation of slow motion.

"How about it?"

After the first one ended, Duan Hao looked at Wu Xiaofu, who of course nodded, "Teacher, leave it to me."

The second patient is an old man with a direct left inguinal hernia. It is not too difficult to deal with it.

After taking a look at the medical records, the old man's main symptom was the prolapse of the hernia mass in the left groin after coughing. Wu Xiaofu touched it and found that it was about the size of a thumb and soft. It should be the transverse colon that had prolapsed from the hernia opening.

For this kind of surgery, if Wu Xiaofu took more than half an hour, his performance would be abnormal.

Although the old man is in good physical condition, at this age, surgery is usually performed with local anesthesia, spinal anesthesia or epidural anesthesia.

Although hernia is simple, surgery or anesthesia can be selected depending on the patient's condition.

If it is a young and middle-aged patient, the patient is in good physical condition, and has no obvious heart or lung function or other basic diseases, it is generally recommended that the patient choose general anesthesia for tension-free hernia repair. After all, general anesthesia can effectively reduce anxiety and tension in patients. , the intraoperative operation will not cause obvious pain symptoms to the patient.

Moreover, with the improvement of technology, hernias are now basically treated laparoscopically. Laparoscopic tension-free hernia repair under general anesthesia has faster postoperative recovery and fewer complications. It can be said to be the first choice now. .

However, elderly patients still need to consider the risks of general anesthesia, especially those with severe cardiopulmonary disease who cannot tolerate general anesthesia. In hospitals, after seeing elderly patients, most of them choose to undergo local infiltration anesthesia. The hernia was repaired.

It’s just that patients undergoing local anesthesia surgery are always awake, which inevitably produces some tension and anxiety, and the surgical operation may also cause referred pain. However, there are advantages, such as faster recovery from anesthesia for patients undergoing local anesthesia surgery. , there were no obvious anesthetic reactions such as nausea and vomiting.

With the popularization of knowledge, doctors actually do not need to explain too much. When patients come, they will take the initiative to express their demands. Not to mention, even young people are more willing to operate under local anesthesia. Although laparoscopy is good, But they all say hernia is a minor surgery. If anyone is willing to undergo general anesthesia, the doctor is willing to accept their opinion. After all, no matter what is done, it is acceptable to them.

After disinfecting and spreading the towel, Wu Xiaofu glanced at the old man.

"Old man, if you feel uncomfortable in any way, please tell me immediately. Don't hold back."

The patient was also adamant, "Young man, just feel free to do it. I have a strong body and I am not that delicate. If you ask me, I can do it or not with this little thing. My child must not be able to do it."

Wu Xiaofu also smiled when he heard this. Almost all the old people of this generation have this idea. If they don't check, they are not sick. Even if they are sick, try not to do anything if they can. However, some diseases really cannot be postponed.

Just like hernia, although the operation may be small, if it is ignored, the harm will be considerable. A hernia is the position of an organ or part of an organ in the body outside of its normal anatomical position.

Because the tissue in some parts of the body is relatively weak or defective, protrusion may occur when the intracavity pressure increases.

Not all hernias require surgery. If it is an umbilical hernia or inguinal hernia that occurs in infants and young children, there may be a possibility of self-healing as the infant grows and develops, and surgery may not be performed temporarily.

However, there is basically no possibility of self-healing for adults with epicutaneous or inguinal hernias, and as the disease progresses, the hernias will become larger and larger. The largest hernia Wu Xiaofu has seen is a 20-centimeter hernia, which is already a serious impact. In daily life, the key is not only the things that affect daily life, but also the harm will gradually increase.

After all, that is an organ staying in a place it shouldn't be. Not only will its function and metabolism be affected, but it may also become incarcerated or strangulated, causing repeated pain or even deterioration. Therefore, it is generally not possible to do without surgery. It would be easier to do it early. If it really reaches the level of 20 centimeters, a minor operation will become a major operation, and the risk of recurrence will also increase.

The scalpel was gently drawn across the line from the left pubic symphysis to the left anterior superior iliac spine two fingers above, making an incision of about five centimeters.

The subcutaneous part is continued to be separated with an electric knife. I have to say that the electric knife is really good. Not only does it cut quickly, it can also electrocoagulate and stop bleeding, which greatly speeds up the process of the operation.

"Old man, do you feel it?"

"Yes, I feel like something is scratching around my crotch."

Wu Xiaofu also laughed. It seemed to be painless. Local anesthesia could not make him lose consciousness. He just had no pain, but he still had touch.

The subcutaneous tissue is separated layer by layer, the subcutaneous ring is explored, the external oblique aponeurosis is opened, the spermatic cord is freed, and the cremaster muscle is incised, the hernia sac will be clear at a glance.

The hernia sac is opened and the hernia contents have retracted.

The characteristic of a hernia is that it can protrude and retract indefinitely depending on changes in body position.

Sometimes it falls out after a cough, but comes back after lifting the air. This is also the difference between indirect hernia and direct hernia.

Lying here, the contents of the hernia are retracted. Many young doctors will fall into trouble here. It is obvious that they have been decomposed layer by layer, but they cannot find the location of the hernia sac. There is no sign of the contents of the hernia. I still have experience. It is required, so when the little doctor starts to do it, there is usually someone with him.

The hernia sac is connected to the abdominal cavity, which is equivalent to opening another channel. This is why the intestines bulge out. Especially when the patient coughs, the abdominal pressure suddenly increases, which squeezes the intestines downward. Follow this channel out, which is the soft lump that the patient can touch.

This is because modern medicine has developed and its popularity is relatively good. In the past, many people were so frightened by this thing that they thought it was a tumor.

"Hemostat."

Taking the hemostatic forceps from the instrument's hand, Wu Xiaofu began to free the hernia sac, then sutured it at a high position at the hernia ring, and casually cut out the hernia sac directly.

"Patch."

The patch is like a small cage cloth. Although it is inconspicuous, it is very useful. When dissociating the hernia sac of an indirect hernia, most people will use a patch to suture the defect of the inguinal canal. At this time, the tension of the patch is relatively high. Small, it can prevent the recurrence of hernia after surgery.

Big hospitals also have an advantage that small hospitals cannot match, and that is that the equipment, patrols, and anesthesia are all top-notch.

They would think along the artist's train of thought, and the equipment would already be ready before Wu Xiaofu could ask for anything.

As soon as Wu Xiaofu finished speaking, the things were handed into his hands.

Wu Xiaofu took a look at the equipment. This one was a new one. Although he was wearing a mask and only exposed his eyes, he looked a bit prettier than the married women before. He was obviously younger. I'm afraid he wasn't allowed to go out yet.

"Xiao Fu, why are you also eyeing our flower?"

The patrolman suddenly spoke. Unlike Xiongqi, who was a stranger to him, the patrolman had already cooperated with him once. When he saw Wu Xiaofu staring at Xiqiu, he said with a smile.

I also caught the opportunity. Wu Xiaofu has a characteristic of surgery. It is easy to get into the state at the beginning. During the period, apart from communicating with the patient, he has almost no other words. This is a little different from other doctors. They think Wu Xiaofu is nervous. , but they were all used to chatting, the chief surgeon didn't speak, and the atmosphere was too boring.

Wu Xiaofu also smiled when he heard this, "I've been here almost every day, why did I see such a beautiful flower growing in the operating room today?"

The weapon didn't expect that the flames of war would suddenly reach him. Moreover, Wu Xiaofu's praise was too direct.

Ordinarily, this young man shouldn't be thin-skinned. How could he be like those old fritters?

Wu Xiaofu could see the instrument's ears turning red, and felt even more interesting.

However, the surgery cannot be delayed. The patch and hernia sac are sutured, the internal ring is placed, and then a few needles are inserted around the periphery and the external oblique muscle, and finally placed directly behind the spermatic cord.

It’s almost over here. A few more stitches are stitched around the inguinal ligament and syndesmotic tendon to strengthen the posterior wall. After careful inspection, it is confirmed that there is active bleeding in the door, and that’s the end.

At the end of surgery, checking for active bleeding is an essential step.

Whether it is subcutaneous, ligament or anywhere else, any small bleeding will affect the healing of the wound if the bleeding is not stopped.

"I'm going to shut up."

Looking at Wu Xiaofu who looked like a normal person after teasing him, Qi Qi secretly sighed and hurriedly started to count the equipment.

Although it is just a hernia sac and it is impossible to drop gauze or the like, the surgical procedure cannot be dropped.

At this time, Wu Xiaofu couldn't help but think of the medical TV dramas he had seen before. The almost essential scenes were gauze and scalpels in the abdominal cavity.

(End of this chapter)

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