In the simple operating room of the emergency department, Chen Dashun was transferred to the operating bed.
During the transfer process, everyone was extremely careful to minimize interference and maintain the stability of blood oxygen.
However, the blood oxygen still pulsates violently, which is related to the low blood perfusion of the whole body. The limited oxygen can only maintain the minimum needs of the cells, so as long as there is a slight interference, the oxygen consumption of the cells increases, and the blood oxygen will be insufficient.
It took several minutes for the blood oxygen to stabilize.
After being anesthetized, Yang Ping quickly washed his hands and disinfected the sheets himself.
Chen Dashun's wounds were all concentrated on the front side of his body. It can be imagined that when he saw the explosion coming, he immediately blocked his brother with his body. The brother was fine, but he was injured by the explosion.
The scattered shrapnel all penetrated the body from the front, cutting and tearing the internal organs.
Yang Ping put on a surgical gown, and Dr. Zhou brought two Yemeni doctors as assistants.
The circulating nurse is a nurse in the emergency department. He usually assists doctors in performing some simple trauma surgeries. The instrument nurse is temporarily transferred from the operating room.
Chen Ershun was guarding the door. The management of this simple operating room was very loose. There was no dedicated guard at this time. People in the aisle could come in at any time, which would not only interfere with the operation, but also increase the probability of infection.
Yang Ping received the knife from the nurse and started the operation.
While he was performing the operation, he informed the equipment nurse in advance to prepare for the next few steps of the operation, so as to save time.
Otherwise, the equipment nurse cannot keep up with the rhythm, and a lot of time will be wasted in the surgical connection.
First deal with the shrapnel in the chest, especially the small piece of iron on the heart.
It was a bomb that could explode at any time. The small hole in the heart that was penetrated by shrapnel. If the tear continued, the blood in the heart would spurt out from the small hole, and the spurted blood would tear the wound even wider.
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A midline sternal incision is made, the chest cavity is opened, and a spreader is inserted.
Cut the mediastinum and open the pericardium.
During the incision and exposure process, the debridement of the shrapnel path was completed and a piece of shrapnel on the mediastinum was removed.
The heart contracts and contracts, and when it relaxes, a small tear is seen on the outer edge of the right atrium.
The tiny shrapnel has been embedded in the myocardium and has not been exposed at all. Now we need to find the shrapnel from the wound and pull it out.
At present, the wound is not a full-thickness tear, and the entire heart is still sealed. Once the shrapnel is pulled out, it is likely that the wound will evolve into a full-thickness tear during contraction and expansion, and the heart will immediately leak and blood will be ejected at high speed.
"There's a deadly piece of shrapnel here, don't move, vascular clamp!"
Yang Ping asked Dr. Zhou to keep the suction device farther away from the upper cleft in the heart. Sometimes, the suction power of the suction device also carries certain risks.
"You said there is a piece of shrapnel here?" Dr. Zhou recalled the CT and X-rays. There was no shrapnel at this location.
"The CT scan is a cross-section. This scan is not a thin slice. It is 10 mm per layer. This piece of shrapnel was missed just now. It is present on the chest X-ray. Unfortunately, it is blocked by the piece on the mediastinum just now, so it cannot be seen."
Yang Ping explained to Dr. Zhou that the mosquito vascular clamp in his hand had been carefully inserted into the crack, accurately clamped the shrapnel, and gently tried to pull it out. After confirming that the shrapnel did not form a barb to hook the myocardium, Yang Ping slowly followed it.
Pull out in the direction of insertion.
With a crisp sound, the shrapnel was thrown into the bending plate, and the blood stained on it immediately spread in the bending plate.
"Syringe with saline!"
Yang Ping used a syringe to gently inject physiological saline to flush the tear on the heart. After flushing several times, he began to suture.
Be extremely careful with every step, and try to be as gentle as possible. Any roughness may cause the entire layer to crack.
The tear on the heart was sutured, and Yang Ping checked whether there was any blood leakage.
After confirming that there is no blood leakage, proceed to the next step, further debridement, remove other shrapnel from the chest, and ligate the damaged blood vessels to stop bleeding or anastomose and repair them.
Insignificant blood vessels are ligated, important blood vessels are anastomosed and repaired, and damaged organs and tissues are precisely repaired.
After the exploration, debridement and repair of the chest were completed, flushing with a large amount of normal saline began.
For open trauma, flushing is very important. Repeated flushing can continuously dilute the concentration of bacteria and minimize the possibility of infection.
After flushing, Yang Ping checked the chest cavity again to confirm that the bleeding had been completely stopped before closing the chest cavity.
It only takes about ten minutes to process the chest cavity back and forth.
This speed and proficiency made Dr. Zhou ashamed. He felt like an intern in front of Yang Ping.
There is no one in this world who can do surgery so skillfully.
After treating the chest cavity, the surgical target shifts to the head.
The entrance of the head shrapnel is on the forehead, and the slender shrapnel is exposed a little outside.
Around the perforation of the skull, Yang Ping incised the scalp, lifted it up after stopping the bleeding, and then used an electric saw to directly open the skull and draw a circle on the skull with the tail of the shrapnel as the center.
This step scared Dr. Zhou to the point of trembling. This electric saw is an ordinary electric saw for orthopedics. There is no safe depth limit. If the hand loses control even slightly, the electric saw will penetrate the skull and damage the brain tissue inside.
Yang Ping was purely trying to save time. He would use whatever operation was quick and he no longer cared about the feelings of others.
The skull was opened, and the electric saw had just made a circular cut, neither deep nor shallow, just enough to penetrate the skull without damaging the meninges, let alone the brain tissue.
Following the passage of the shrapnel into the wound, Yang Ping incised the meninges and brain tissue, removed the shrapnel and the hematoma around the shrapnel, then rinsed it and double-clicked electrocoagulation to stop the bleeding.
Yang Ping couldn't help but feel secretly happy. This Chen Dashun was indeed Dashun.
The sharp shrapnel inserts into the gap between the brain tissue grooves, causing very little damage to the functional areas of the brain tissue.
But Yang Ping is still worried that trauma will bring some sequelae. In addition to damage to functional areas, scars left behind after the brain tissue heals may disrupt the brain's electrical discharge, causing epilepsy.
Irrigate to stop bleeding, repair brain tissue and meninges, and close the skull.
This step is accomplished easily.
Any one of these injuries would be a difficult operation for a trauma surgeon. Putting these operations together, the difficulty of the operation can be imagined.
This chapter is not over yet, please click on the next page to continue reading! For other doctors, a surgical team of more than a dozen people, including neurosurgery, thoracic surgery, general surgery, urology surgery, and orthopedics, would have to take turns to complete the operation.
Now Yang Ping initiates the surgery alone, and it is very easy to do it.
He alone can support a team!
No, even a top trauma surgery team cannot match his speed of surgery.
Dr. Zhou finally understood why Professor Yang dared to operate under such simple conditions. Such skilled surgical techniques had reached the point where he could do whatever he wanted.
After the treatment of the craniocerebral injury was completed, Yang Ping began to open his abdomen.
After opening the abdominal cavity, he conducted a comprehensive examination of the liver, gallbladder, pancreas, spleen and gastrointestinal tract, removed the shrapnel one by one, and repaired the damaged organs one by one.
Soon, all the abdominal surgeries were completed, and finally the limb surgeries were performed.
Whether it is exploration and repair of axillary brachial plexus nerves and blood vessels, or skin flap repair of skin defects.
I saw that Yang Ping had toothed forceps in his left hand and tissue scissors in his right hand. Contaminated tissue, inactive tissue or foreign matter were all removed, and he was advancing step by step.
With thorough inspection and high-quality repair, every shrapnel seems to need no positioning and can be found and taken out directly every time.
This super surgery actually looks as simple as a small debridement and suturing. Dr. Zhou has seen the power of this master of trauma surgery.
With such speed and proficiency, it's like knowing the anatomy of the human body without even looking.
Dr. Zhou, an assistant, could not keep up with Yang Ping's speed. Many times, Yang Ping had to complete a lot of the assistant's work himself.
Slowly, the shrapnel was removed, the bleeding was stopped, the blood transfusion continued, and the blood pressure naturally rose slowly.
The last wound was treated and all the shrapnel was removed.
Yang Ping looked at Chen Dashun, who was almost all covered with auxiliary bandages and said:
"Send him to the observation room for continued blood transfusion and fluid replenishment, and he will be given antibiotics for a week to prevent infection."
Today I saw the world's top level, and Dr. Zhou seemed to feel that what he saw was unreal.
For such a complex and multiple injury, the whole process took only two hours, and the operation was completed.
Dr. Zhou calmed down and called the director of the emergency department to come in and arrange for post-operative care.
The Yemeni director rushed in, thinking that the wounded man was dying on the operating table, but he looked at the good electrocardiogram on the monitor.
Ask Dr. Zhou: "What's going on?"
"After the operation is completed, we will monitor the ward and arrange for two nurses to guard it." Dr. Zhou said weakly.
Two hours? Is the operation completed?
Director Yemen looked at this and that, hoping someone would give a different answer.
At this time, Manager Qiu and Chen Ershun came in. He saw everyone taking off surgical gowns and thought Dashun was not saved.
Chen Ershun's mind went blank for a moment, like a fool: "Brother! Brother - what's wrong with you?"
The sound was like thunder, extremely miserable.
"What are you shouting for? If you have the strength to help with the bed, send him to the observation ward for monitoring." Yang Ping scolded him.
Originally, everyone was very happy after the operation, but his sudden voice startled everyone.
"Professor Yang, how are you?" Manager Qiu looked at Dashun on the operating table.
Yang Ping said calmly: "The operation was successful. There were no accidents after the operation. There should be no major problems."
This guy's physique is really strong. If it had been someone else, he wouldn't have been able to last this long with such an injury and so much blood.
"Help me cross the bed. What are you doing standing there in a daze?"
Yang Ping pushed Chen Ershun.
Chen Ershun immediately realized that his brother was alive.
Looking at the rising blood pressure, Yang Ping felt relieved.
As long as he is transferred to Saudi Arabia after the operation and receives careful postoperative treatment, Chen Dashun should be able to survive.
