Chapter 187 So cool! (Please subscribe)

Joint infection is an eternal topic in joint surgery.

This situation is like infection after surgery. As long as surgery exists, the topic of postoperative infection will never go out of style, because in reality, bacteria and other microparticles are everywhere, throughout every step of the treatment process.

, may lead to infection.

This is an established complication of all surgeries.

For a surgeon, it is inevitable that infections will occur in all of his surgical patients. The reason why he has never encountered them is because the number of patients is not enough.

Currently, the gold standard definition of joint surgery for the treatment of joint infection is one-stage debridement and two-stage surgery.

If it is a natural joint infection, the first stage is debridement, and the second stage is joint replacement or joint fusion or other surgeries depending on the situation.

If infection occurs after joint replacement due to surgery, the first stage of postoperative debridement will be performed, bone cement and antibiotics will be placed during the operation, and the joint revision surgery will be performed in the second stage.

This is a safer measure.

However, Professor Zhuang Zhou said that whether it is a joint infection that occurs naturally or a joint infection caused by postoperative infection, thorough debridement can be performed in one stage, and then the joint can be treated in the next stage of surgery.

Therapeutic treatment such as replacement or revision.

This is equivalent to merging the second-stage surgery into the first-stage surgery. In the past, this surgical method was an absolute contraindication!~

A person who treats commonly understood taboo surgeries as routine surgeries and even dares to talk about them.

First of all, I can only say that I am very courageous——

Because according to the current guidelines, the gold standard for all infection treatments is two-stage surgical treatment.

Only senior officers have the right to perform surgeries and treatments that violate the guidelines, and if something goes wrong, the person who led the team or performed the surgery will have to take responsibility!

Is one-stage surgery good?

Of course, it is good. It not only saves the time of surgery, but also allows patients to recover as soon as possible, and also reduces their hospitalization expenses and medical time.

But the risks are extremely high from a traditional perspective.

The standard treatment method written in the guideline is to perform two surgeries, one-stage surgery, which consumes time and money. Once anything happens, the doctor will be held responsible.

Under such circumstances, the ability of a professor who dares to take such a risk and perform surgery against the guidelines goes without saying.

This is a relatively new understanding and field, it can also be said to be a new vision and concept, but it has not yet become a consensus...

There is still a long way to go before consensus can be reached.

However, Zhou Cheng listened to Professor Zhuang Zhou’s summary——

Professor Zhuang Zhou used a very formal summary——

take home message (key points and summary):

This usually appears in more formal literature submissions, but Professor Zhuang Zhou wrote it in the ppt, which proves that he put a lot of thought into making this ppt.

"Joint infection can be treated in one stage, but there are a few key points that you must pay attention to."

"First, before the operation begins, the infecting bacteria must be identified. It is best to conduct a drug sensitivity test. Units that have the conditions can form a joint collaboration group with the laboratory department!"

"Second, there must be a sufficient time limit for the use of sensitive antibiotics before the operation begins."

"Based on our experience, it is recommended that sensitive antibiotics should be premedicated for 24 hours before surgery. For those with limited conditions, more than 12 hours can be used."

"If sensitive antibiotics are not used before surgery, the duration of antibiotic use after surgery can be appropriately increased by 3-5 days, which can also reduce the chance of postoperative reinfection."

"Third, during the operation, complete debridement, remove all infected tissue, and clean the hidden spaces of infection, including muscle spaces and intra-articular blind spaces. During this process, do not open new spaces!"

"Fourth, antibiotic carriers can be appropriately utilized during surgery."

"Fifth, continuous drainage after surgery. If conditions permit and the patient is satisfied, continuous flushing and drainage can be performed."

"Sixth, adequate postoperative treatment, timely drainage of fluid, culture of exudate, and timely adjustment of the dosage and duration of antibiotic use. The recommended postoperative antibiotic use time is 96-120 hours!"

"Seventh, proper rehabilitation training after surgery..."

"These are the pre-operative, intra-operative and post-operative photos of some of the cases we did. Please supervise me..." Zhuang Zhou was calm and composed, as if I came here to study, but in fact, he was full of

It's all about showing off and showing off.

When Luo Yun heard this, he smiled slightly, shook his head, and then turned around to see Zhou Cheng. He actually took a notebook and carefully copied out everything Zhuang Zhou said.

Then he asked with a flash of his face: "What are you doing?"

"I think what Professor Zhuang said is quite good, so I took notes so that I can think about it in the future." Zhou Cheng recounted Du Yanjun's remarks.

But in fact, Zhou Cheng felt that the new direction in the treatment of joint infections that Zhuang Zhou just talked about was tailor-made for him.

Isn't this a new breakthrough point and perfection in the treatment of joint infections - a redefined realm?

Zhou Cheng even skipped the idea of ​​​​simulation. He just took the idea that Zhuang Zhou just explained and practiced it once or twice in the simulation world. I'm afraid he would be able to get perfect-redefined skills. Isn't this a good thing?

So Zhou Cheng naturally had to write it down quickly. As for what Professor Zhuang Zhou said, it would take time to verify the specific effect. Zhou Cheng did not need to consider this factor at all.

The existence of the simulator allows him to have many trial and error opportunities and more trial and error time costs.

If it doesn't work once, I'll do it twice. If it doesn't work twice, I'll do it ten times. It'll finally work, which is three to five days' work.

Luo Yun's expression continued to be weird, he knocked on Zhou Cheng's notebook and said, "Don't you see that these other people only think that Professor Zhuang Zhou said that, and we listen to it like this?"

"Have you ever seen anyone taking notes like you?"

Zhou Cheng followed what Luo Yun pointed and saw that no one was taking notes. Many people even had their hands folded on their chests, as if they were not listening to the lecture but watching the fun.

After Zhou Cheng finished recording, he was listening to Zhuang Zhou's concluding remarks, and while being slightly distracted, he replied: "Teacher Luo, I am the stupid bird who flew first."

Zhou Cheng feels that learning is personal, not shared. He is not someone else. Others are either associate professors, directors somewhere, or graduate students.

There is no need to study for an associate professor or a director somewhere. Graduate students each have a better learning platform!

Zhou Cheng himself didn't have this opportunity, so naturally he could take more notes.

Opportunities to learn are precious and hard-won.

Seeing that Zhou Cheng was serious, Luo Yun rolled his eyes and said, "Do you really take Professor Zhuang's pretentious words seriously?"

"Do you know that Professor Zhuang, the reason why he dares to carry out the first-stage treatment of joint infection in his unit has certain background factors?"

"First of all, his affiliated hospital is Xinjiang Medical University, which is located in Xinjiang Province. Did you know that Xinjiang Province has an excellent medical insurance policy? Basically, major surgeries like this are completely covered by medical insurance.

"

"In other words, over there, ordinary people's joint replacements are all paid for by medical insurance, and the patients themselves don't have to pay anything."

"So, neither the patient nor the doctor are afraid of having the joint prosthesis repaired for the second time. The worst that can happen is to install another one. The patient doesn't have to pay for it himself, but he just has to suffer a little bit, and he can tolerate it."

"But anywhere else but here, could you repeat that?"

"It cannot be repeated, and this unique geographical advantage is the fundamental reason why Professor Zhuang dares to do this. It is useless for you to take his notes."

"As long as Professor Zhuang does not have the ability to change the guidelines and obtain widespread recognition around the world, what he says is actually quite superficial."

Luo Yun spoke very thoroughly, making Zhou Cheng's eyes widen slightly.

Is there still such a thing?

Co-authored, others just quietly let Zhuang Zhou finish his pretense and go through the motions, and then he took it seriously?

Zhou Cheng has never had the opportunity to participate in such an academic exchange before!

However, Zhou Cheng just discovered that this kind of academic exchange is simply tailor-made for his simulator——

The details Zhuang Zhou said were very substantial. He had just tried a simulation according to Professor Zhuang Zhou's ideas.

It is completely based on the ideas taught by Professor Zhuang Zhou, and you don’t have to design anything yourself.

The third copy that Zhou Cheng got at the emergency scene some time ago was the bone and joint copy, which is consistent with the joint surgery conference and exhibition hall he came to today.

Then--

Zhou Cheng gained experience in treating joint infections (initial/post-operative) in one go (perfect - world-defining level).

Once it entered the soul, although it failed to directly break the rules as Professor Zhuang Zhou said, it still reached the perfect level in one go!

"But I think what Professor Zhuang said is quite reasonable?" Zhou Chengcheng touched his head and asked Luo Yun.

What Professor Zhuang Zhou said was definitely not false, but it was not recognized!

"Principles are principles and implementation is implementation. Just keep listening. You will feel that everything the professor says makes sense."

"Let me tell you this. In fact, academic exchange conferences like this are just large-scale show-off events. What you want to see is who can brag. Anyway, if you brag, as long as you don't brag yourself and can justify yourself, you will be great.

." Luo Yun continued to roll his eyes, feeling that the notes made by Zhou Cheng were really unnecessary.

Even if it is right, can it be done right?

cannot.

Why should you pay attention to something that cannot be made, or even something that will take an unknown number of years to be promoted?

Without medical insurance, you can’t replicate this model anywhere else, you just have to follow the existing guidelines!

"Professor Zhuang is the kind who is particularly good at boasting." Luo Yun explained to Zhou Cheng again.

So he just forced Wang Zhuangzhou?
To be continued...