In the next week, Tanglou changed the dressing basically every day. As usual, the last suture was done at noon and the last suture was done in the afternoon.

By the sixth day, basically all the patients in the ward knew that there was a young and handsome doctor who had first-class dressing-changing skills, fast speed, and gentle techniques, and rarely had infections or blood infiltration.

In the ward, the patients who were injured in the chemical plant explosion were also secretly stunned, and their eyes lit up every time they saw Xu Lanlan.

"Nurse Xiao Xu, look, have you arranged for me to have Dr. Xiao Tang change the dressing?"

The patient in bed 11 licked his face and called out to Xu Lanlan. These days Xu Lanlan is like the spokesperson of the tenement building, taking away a few lucky people from the ward every day.

"Dr. Xiao Tang has changed enough dressings today. Dr. Leng will change your dressings later."

Xu Lanlan firmly controls the number of times in Tanglou every day, otherwise the guy will not be restrained at all, and he will really come as much as he wants.

Therefore, Xu Lanlan now calculates her time every day and leaves a certain amount of rest time between each patient.

"It's Doctor Leng again, ugh."

The patient was obviously disappointed when he was not selected by Xu Lanlan.

It’s not that Leng Yunze’s skills are not good, it’s just that after all, Tanglou has the surgical master bond bonus. For a day or two, everyone just thought that changing Tanglou’s dressing would reduce the pain, but after four or five days, it was obvious that Tanglou

The patients who underwent dressing change were better than other interns in terms of healing speed and infection rate.

After a while, bed 11 was brought into the dressing room reluctantly.

Bed 11 looked at Leng Yunze, Leng Yunze looked at Bed 11.

11 Turned his head on the bed, lay down, took out a small wooden stick and bit it as a spare, it was very hard: "Come on, hurry up~"

It doesn't matter whether Leng Yunze does it or not. Is it so painful for him to change the dressing?

The atmosphere was slightly awkward.

Leng Yunze feels aggrieved by eating leftovers from a tenement house. If you don't like it, I won't like it anymore.

The patient felt angry that his sign had not been turned over, and was overcome by pain.

When Bai Fumei followed Gao Fushuai, Xiaozizi and Xiaozizi were left looking at each other with disgust...

...

When bed 11 and Leng Yunze disliked each other, bed 20 walked out of the dressing room happily: "The dressing that Dr. Xiao Tang changed was good, and it didn't hurt at all."

“…”

...

Soon the first week was over, and the batch of patients handled by Tanglou had basically recovered.

Tanglou looked at the harvest of the week:

Level 4: Upgrade 20

Surgery column (4/4): suture (three stars, 9), diagnosis (one star, 3), incision (one star, 1), dressing change (three stars, 9)

Gold coins: 5

Bond (1/1): Surgical Hand (Level 1, 3/5)

Talents (3/3): 1. Suture assembly line (activated): 2. Listening (active skill, cooldown time of one day) 3. Resilience: During surgery, the host’s physical endurance is increased by 50%

Storage column (4/9): Debridement (two stars, 6), Hemostasis (one star, 1), Exposure (one star, 1), Emergency Comprehensive Surgery (three stars, 9)

...

The training content of the second week is incision surgery.

This week is naturally more demanding than changing dressings, and the screening of patients is also stricter.

Moreover, incision is only the prelude to surgery, and the entire surgery still needs to be performed by the attending physician.

With the agreement between Huo Tong and Liu Tong, a total of five patients were screened and arranged this week, with Liu Tong as the surgeon and Tang Lou as the first assistant.

The first case is an acute appendix surgery.

Liu Tong takes the lead, with Tang Lou as the first assistant and Leng Yunze as the second assistant. Under normal circumstances, one assistant is enough for a small surgery like appendicitis. Considering Tang Lou's physical strength, he is only responsible for incision. Leng Yunze, the second assistant, to put it bluntly

It's just a simple hook.

Acute appendix is ​​a very common disease in surgery, and appendectomy is one of the most common and commonly performed operations.

This patient is a 34-year-old male with suppurative appendicitis.

After rehydrating the patient and correcting water and electrolyte balance disorders, the anesthesiologist performed spinal anesthesia on the patient.

For appendicitis, Liu Tong was naturally very familiar with it and adjusted the patient to the supine position.

Liu Tong took a pen and began to draw the incision line on the patient's abdomen. At the same time, he said to Tang Lou and Leng Yunze:

"Generally, for appendicitis surgery, we will make a McLaren incision. Of course, if the diagnosis is not very clear, a midline abdominal incision can be made. Appendicitis surgery is generally easy to operate, but sometimes it is difficult, such as ectopic appendix."

"Since the position of the ectopic appendix often varies, the tenderness point can be used as the appropriate incision to expose the appendix."

After Liu Tong finished speaking, Tang Lou nodded aside. Leng Yunze wanted to take a step closer to see the incision, but as the second assistant, naturally he couldn't get close.

"So angry."

Leng Yunze felt really aggrieved. In the past, he was the first to assist Liu Tong in his minor surgery, but as soon as this tenement house came, he fell out of favor.

"I used to call him Xiao Lengleng, but now I call him that second assistant."

After Liu Tong drew the location of the incision, he explained to Tanglou:

“The principle of surgical incision is to fully expose the surgical site and facilitate surgical operation. The ideal incision should:

First of all, it is closest to the surgical site, preferably directly to the surgical area.

Second, the incision should be parallel to important structures and the direction of the incision should be consistent with the course of important blood vessels to avoid damage.

Third, try to be as beautiful as possible without leaving ugly scars. For example, in addition to conventional appendectomy, there is also umbilical endoscopic appendectomy in China, which has the characteristics of less trauma and quick recovery.

Of course, there is also the most famous endoscopic retrograde appendicitis treatment, also known as ERAT, pioneered by Professor Liu Bingrong of the Second Hospital of Harbin Medical University in China.

After ERAT, the patient's abdominal pain is relieved immediately, and he can go home or return to work without the need for hospitalization."

Tang Lou and Leng Yunze are naturally yearning for it. ERAT technology is very famous. Of course, the most impressive thing is what Professor Liu said on the home page of the PPT where he proposed the plan:

"ERAT——made in a"!

When the two young men were excited, Liu Tong directly poured cold water on them: "You don't have to think too much now. It would be good if you can do the most basic appendectomy well. As for the umbilical cavity technology, it is

Even I have never done it. As for ERAT, there are less than three people in the province who can do it. Hecheng, even none."

"Oh~"

Leng Yunze's eyes quickly darkened. Liu Tong was right. He would take over Huo Tong's class from now on. He would work there for several decades and then, if things went smoothly, he would get into his uncle's position and become the deputy dean.

Leng Yunze looked at Tanglou again. If this guy got into the first city hospital, he might not have the opportunity to participate in the umbilical cavity appendectomy. Of course, he would only participate.

As for ERAT, don't even think about it.

Liu Tong continued to teach Tanglou: "In addition, fourth, we must pay attention to the incision to avoid crossing the joint so that the function will not be affected after recovery."

"The last point and the most critical thing is to fully expose the surgical site and make it easy to extend. Just press the incision line I set and start."

Tanglou nodded, took the sharp scalpel from the instrument nurse, and used the most commonly used bow-holding style.

The blade of the knife scratched the patient's skin, followed by the subcutaneous tissue, and then saw the white and strands of aponeurosis on the red external oblique muscle, which was smoothly incised.

"Second assistant preparation, blunt dissection, and retraction of the internal oblique and transversus abdominis muscles."

Naturally, Leng Yunze quickly prepared the hook, opened the incision in the Tanglou, and fixed it, fully exposing the surgical field.

Liu Tong looked at Tanglou's incision and was very satisfied. After all, it was amazing to be able to do it like this for the first time. Thinking back to the first time he went on the operating table to make an incision, the first cut was not strong enough and the length of the cut was not enough.

, added a second line, and was barely exposed.

After completing the incision, Tanglou stepped aside and continued to assist with the next steps.

As for Leng Yunze, he just needs to be a good guy and keep his hands tight.

Liu Tong continued the appendectomy, carefully fixing the peritoneum to the skin, and then gave the order:

"Take the peritoneal exudate for bacterial culture and drug sensitivity testing."

After completing this step, the most critical step is to find the appendix, which is commonly known as turning the intestines.

At this time, Liu Tong was also very serious. He carefully found the ascending colon first and took it along the colon to the ileocecal part.

The movements are naturally very skillful, and the place where the three colon bands come together is the root of the appendix.
Chapter completed!