After Cai Dongfan and Luo Yun arrived in the lounge, they immediately lit a cigarette and stuffed betel nuts into their mouths.
The irritation of betel nut immediately gave rise to a hiccupping and nauseating feeling that was very uncomfortable. However, the painful stimulation in the mouth and the choking feeling in the throat also made Cai Dongfan and Luo Yun instantly sober.
The eyes of both of them were quite dim, not because they were desperate for life, but because they were really tired.
However, not long after Luo Yun sat down, the phone on the table vibrated. When he picked it up, he saw that it was the hospital's internal landline number.
"Hey!~"
"Are you Dr. Luo Yun from the Department of Orthopedics? I'm the outpatient guide. It's already past 8:40. Doctor Luo, why haven't you come to the outpatient clinic yet? The patients here are almost noisy." Another phone call
At one end, an urging female voice sounded.
Luo Yun's brows froze tightly at that time: "Didn't I call the general manager of the hospital yesterday and cancel my outpatient clinic today?"
"I don't know. It hasn't been cancelled. We haven't received a notice. Now the outpatient patients have arrived at the door of the clinic. There are more than 20 of them. I just said that Dr. Luo, you are doing rounds and you have to wait for a while, but this is all
It’s almost nine o’clock.”
"I can't hold you back any longer." The person on the other side was complaining to Luo Yun, hoping that he would hurry over.
Today is Sunday, and it is also Luo Yun’s second outpatient visit.
Luo Yun felt that his balls were hurting.
He knew about today's outpatient clinic, but something special happened yesterday, so he called to say he wanted to cancel the outpatient clinic, but it hadn't been arranged yet. Now, the operating room has been opened.
The patients from the outpatient clinic have already arrived. Isn’t this nonsense?
"Don't the patients who come for treatment know what happened yesterday?" Zhou Cheng lowered his voice and asked.
"I know, but they said that after they registered, they had to see a doctor. What happened yesterday was the hospital's problem. Isn't it possible that such a big hospital can't even arrange this?"
"Doctor Luo, what do you think we should do now?" The outpatient guide was cautious and did not dare to threaten Luo Yun directly.
But if Luo Yun never goes, then they won't keep delaying it, and it's not their fault.
"Alas!~~~"
Cai Dongfan's eyelids were twitching. After taking a deep breath, he said: "Go to the outpatient clinic. Luo Yun!"
"What about this operating room? What to do?" Luo Yun looked at Cai Dongfan in embarrassment.
Although this is not Luo Yun's problem, it is because the incident happened suddenly, but today, three operating rooms have been arranged for their team to perform emergency surgeries as soon as possible. If he is missing a surgeon, the operating rooms will be taken back.
Not to mention, I don’t know how long it will be postponed after today’s surgery is over.
However, when the emergency rescue in the general department was carried out yesterday, someone from his team was not present, namely Zhou Cheng, who went to the on-site emergency team. Yan Haihan had some words to say, although he did not say it in person.
If Luo Yun had slipped away today, I don't know what Yan Haihan would have said.
"The number for the outpatient clinic has been released. I'll think of a solution!" Cai Dongfan's little eyes kept moving, obviously thinking about what to do.
There are still too many patients and too few doctors!
Moreover, Luo Yun had already said in advance that he would cancel the outpatient clinic. Either the medical department was not good enough, or the outpatient office was sneaking around. What could be done?
Can I go to the outpatient clinic or medical department to make a noise?
Doctors also have the human sophistication that they should have. It is not that people are sophisticated, but that sophistication will find you unconsciously.
Luo Yun had no choice but to put out the cigarette butt, and then hurried towards the clinic.
After registration, there is no official notice from the hospital and the hospital communicates with the registered patient about changing the number or refunding money. Then a diagnosis and treatment relationship is established, and one report is accurate.
At that time, the outpatient department and medical department will not tell you any other reasons. Once you have released your number, you will have to see it.
However, in order to reduce time, Luo Yun still called the outpatient department immediately and asked them to stop his number. He also asked them to notify registered patients that they should come to the clinic in the morning.
This is the only solution Luo Yun can think of.
Shortly after Luo Yun walked out, Cai Dongfan spit out the betel nut residue, put out his cigarette butt, and re-entered the operating room where Zhou Cheng was.
When he entered the operating room, he saw Zhou Cheng alone, so he asked: "Xiao Zhou, where is Du Yanjun? Has he escaped?"
He thought Du Yanjun had sneaked back and was lazy.
The tone and mood are a bit off.
Zhou Chengdao: "I asked Yan Jun to go down and rest for a while. After the patient is brought in, he will return to the operating room. I guess he has only arrived in the lounge not long ago. Teacher Cai, do you want to see Yan Jun?"
Cai Dongfan's previous arrangement was that Du Yanjun followed Zhou Cheng, who led him to the seaside, and then Luo Yun led Zhang Zhengquan.
But now that Luo Yun has gone to the outpatient clinic, the surgery schedule has to be readjusted.
"Well, he can't go to rest! Luo Yun has gone to the outpatient clinic, and he has to go to the 19th surgery room. Then I will ask Zhang Zhengquan to come to your place to help."
"Damn. What's going on today?" Cai Dongfan cursed and walked out of the operating room, took out his cell phone, and dialed Du Yanjun.
Du Yanjun just lay down. After hearing this, he quickly stood up again, dragging his tired body, and started fighting intensively again.
Moreover, because there was no one to help, he had to go to the 17th room first, and then asked Zhou Cheng to go to the 19th room to help lift his legs, disinfect and spread the towels.
When there is no one around, one person can only support several people.
After doing this, Du Yanjun had time to look at the patient.
This is an open injury to the knee joint with exposed blood vessels. It is a rather complicated debridement surgery!
Du Yanjun's scalp was beating, and he was a little at a loss when looking at the patient.
However, the anesthesiologist and circulating nurse all looked at him.
There is no hand-washing nurse in this operation. Yesterday's hand-washing nurse was exhausted and went back to rest. Most of the nurses who came to work today are on duty!
Although I can wash my hands, when I get on stage, there is no one to take things or help me off stage.
Zhou Cheng walked out of the door and looked at the operating room in Room 17 which was still empty. Then he turned back and gave instructions to the people in Room 19: "After the patients in Room 17 are anesthetized later, ask me to come on stage."
"Let me take the stage here first."
Debridement and suturing are also very particular. Strictly speaking, simple debridement and complex debridement should not belong to the same level of surgery. However, when grading operations, they are all classified as debridement and suturing.
Just a technique.
Zhou Cheng knew that such a third-degree open knee injury was not something Du Yanjun could handle.
This kind of open injury of the knee joint is a completely minor case in an emergency scene, because the task of the emergency scene is to transfer the patient to the hospital to save his life.
When you get to the emergency department, it's just a bit tricky. The emergency doctor's purpose is to bandage it, stop the bleeding, and then transfer it to a specialist.
After entering a specialist, the real treatment actually begins!
The most basic principle is to save lives first and then treat patients.
However, just saving lives is obviously not the ultimate purpose of medicine, it is only the most basic purpose.
It's like an open trauma to a joint.
Open bones and joints can be divided into three grades according to the severity of the injury:
First degree: The skin is punctured from the inside to the outside of the fracture. The soft tissue is slightly damaged or the joint capsule is pierced by a sharp instrument. The wound is small, and the articular cartilage and bone path are not damaged.
Second degree: The skin is cut or crushed. The subcutaneous tissue and muscle tissue are moderately damaged or the soft tissue around the joint is extensively damaged. Articular cartilage and bones are partially destroyed, and there are foreign bodies in the wound.
Third degree: There is extensive and severe damage to the skin, subcutaneous tissue, and muscles or damage to the soft tissues around the joints, ligament rupture, severe damage to articular cartilage and bones, foreign bodies in the wound, combined with blood vessels, nerve damage, or joint dislocation.
If it is a first-degree injury, it can be treated as septic arthritis without excessive debridement.
Du Yanjun gritted his teeth and tried debridement of the second-degree open joint injury. However, debridement and suturing of the third-degree joint injury required not only the removal of necrotic tissue, but also the reconstruction of muscles and ligaments.
Anastomosis of blood vessels and nerves may even be required, and such debridement is not simple.
And this kind of patient, at the emergency scene and among the open trauma, is relatively minor!
When Du Yanjun heard Zhou Cheng's words, he felt as if he had been amnesty and had met a savior. Just now, when Cai Dongfan asked him to come on stage, he was a little happy. He thought that he had been recognized by Cai Dongfan and felt that he could be the chief surgeon.
Had surgery.
But after entering the operating room and seeing the patient's condition, I immediately felt at a loss.
Zhou Cheng washes his hands, dresses and wears gloves!
"Tourist, please apply the tourniquet. The pressure of the tourniquet should not be too high!" Zhou Cheng ordered.
Open joint injuries are accompanied by vascular injuries. If the pressure of the tourniquet is too high, the open vascular injuries may not be discovered, making the debridement surgery incomplete, or the vascular injuries that should be discovered cannot be discovered.
This is ridiculous.
"Open another lower limb fracture bag." Zhou Cheng gave another order after glancing at it for a few times.
The instruments in the lower limb debridement package and the fracture package are different. Although some of them are repeated, if you have some of the instruments in the fracture package, the operation can be carried out more smoothly!
"Yan Jun, let's explore together. You look for foreign objects, and I'll look for blood vessels!"
For injuries of a destructive nature, the blood supply must first be found out. This is the first prerequisite for judging whether the limb can be salvaged.
If the blood vessel damage is serious, don’t even think about it. Either a blood vessel transplant or amputation!
If he leaves simple matters to Du Yanjun, there will definitely be no problem.
It was complicated that Du Yanjun couldn't handle, so Zhou Chenggong picked it up by himself.
Otherwise, if I keep procrastinating, I will waste a lot of time loving you.
"Okay! Brother Zhou Cheng." Zhou Cheng came to the side, so decisive and straightforward, which gave Du Yanjun a backbone!
There was even a feeling of tears filling his eyes. He, who just now was running around like an ant without a leader, quickly gathered his thoughts——
He immediately used a suction device to suck out the blood clots on the surface one by one, and then used a thyroid retractor to slowly move toward the inner layer.
During on-site first aid, although most of the debris or foreign objects will be removed, it is impossible to remove them completely. You must carefully explore during the operation to ensure that there is no residue.
While Du Yanjun was looking for the foreign object, Zhou Cheng had already begun to quickly judge the anatomy.
The arteries at the knee joint mostly focus on the popliteal fossa.
Fortunately, the patient's open joint is in the front. Therefore, the popliteal fossa may be protected and not involved, but the blood vessels under the popliteal fossa, that is, under the tibial plateau, need to be carefully explored.
Moreover, it is necessary to straighten out the shape of the muscles at the origin and insertion points of the tibial plateau, identify the tendons and muscles one by one, and then reconstruct the bone defects and muscle insertion points...
The treatment of simple bone defects is very simple, and Zhou Cheng can also do a simple reconstruction of tendon insertion points.
But when both exist at the same time, the difficulty is not as simple as one plus one, or even a simple exponential increase!
Instead, it directly raises the difficulty level to several or even hundreds of times!
Do we need to reconstruct bones, do we need to reconstruct tendons, and how?
Can muscles grow without rebuilding bones? What if muscles atrophy without rebuilding tendons?
What should I do if my tendon is reconstructed but the reconstructed bone is strained?
The reason why surgery is complicated, or the reason why some diseases are complicated, is because there is no very logical one-to-one correspondence.
We can't even find a perfect corresponding means that is perfect and consistent.
However, this issue should be considered later.
While Du Yanjun was picking out stones, broken gravel, glass pieces and blood clots, he secretly looked at Zhou Cheng and discovered that Zhou Cheng had exposed the corresponding blood vessels and nerves without knowing when.
Come out!
The nerves were held aside by Zhou Cheng with cut rubber gloves, and the blood vessels were fixed with silk threads.
Moreover, Zhou Cheng's fixation is not the kind of fixation that is tied off, but a living knot.
The dead knot was above the blood vessel, which did not tie off the blood vessel, but could pull the blood vessel out. At the same time, he also classified the broken muscles and clamped the tendons with vascular clamps.
Vascular clamps cannot clamp muscles, because this will dissolve the muscle tissue, leading to death similar to rhabdomyolysis. But tendons can be clamped. There are no blood vessels in the tendons, so the clamps will not dissolve!
However, after Zhou Cheng finished doing this, the tours of the Seventeenth and Nineteenth Rooms came to urge him.
Said: "The anesthesia in Room 17 has been done, and Dr. Zhang over there has done the disinfection. I want to ask Dr. Zhou, do you want to go there?"
"I'll be right over!" Seeing this, Zhou Cheng immediately got off the stage!
Untie your gloves and clothes at the same time!
"Brother Zhou Cheng, what is this?" Du Yanjun panicked when he heard that Zhou Cheng was about to step down.
If this operation was completely left to him, he wouldn't be able to handle it.
Now it is no longer a matter of chance, but the situation encountered is beyond the scope of ability, and Du Yanjun cannot handle it.
Although he really didn't want to admit that he was much worse than Zhou Cheng, in fact, he had already recognized the fact that Zhou Cheng was the junior superior in the group. When Zhou Cheng was here, he felt very at ease, as long as he did good things
.
Everything can be left to Zhou Cheng. Before Zhou Cheng came on stage, he panicked a lot!
Now that Zhou Cheng is leaving, he is still panicking.
When there are many opportunities, being unable to seize them is a feeling of powerlessness!
"Debridement first, don't worry!" Zhou Cheng calmly comforted Du Yanjun.
Zhou Cheng must step down.
Seventeen is his main battlefield, this is one of the reasons!
The second thing is that he has already investigated this patient clearly, and can let Du Yanjun slowly remove the foreign body, and then clean up the necrotic tissue. At least this way, the patient's life will not be in danger!
But he hasn't seen what's going on over there next door, so he still has to take a look first to know what's going on!
If this kind of III-degree open knee injury is a minor debridement, then the situation next door will definitely not be much worse. If Zhang Zhengquan is left to bear it alone, if something goes wrong, it will be troublesome.
.
Still not enough manpower.
Teacher Luo.
"Yan Jun, don't throw away these broken bones. Put them in a curved plate later and soak them in complex iodine. I'll go over and take a look at the situation," Zhou Cheng ordered.
It was a helpless thing for Luo Yun to go to the outpatient clinic, but after the person left, the patient still had to be handled by someone, and there was no way to run away!
He only hoped that the twenty-one rooms on Cai Dongfan's side could be completed as soon as possible, and then an operating room could be replaced in the gap.
Otherwise, Zhou Cheng would really feel a little unfocused when running on both sides.
You have to be dedicated when doing surgery.
"Okay, Brother Zhou Cheng." Du Yanjun was a little panicked when he saw Zhou Cheng leaving. He was also a little afraid that the patient would suddenly disappear after Zhou Cheng left.
However, after Zhou Cheng had sorted out the muscles, blood vessels and nerves, the operation was actually not that difficult, and he could start walking step by step.
Zhou Cheng went out, washed his hands directly, and then entered Room 17.
While putting on his clothes, he asked directly: "Quanzi, what is the condition of this patient?"
"Arterial embolism, plantar damage, and amputation of the middle and lower legs!" Zhang Zhengquan hurriedly replied. He also understood the patient's condition clearly in advance!
Zhang Zhengquan knows.
Luo Yun suddenly left, and Du Yanjun next door couldn't handle it alone. Zhou Cheng was helping next door before, and he wasn't in the hospital yesterday. He didn't do ward rounds in the morning. He definitely didn't have time to understand so many things.
"How long has it been tied?" Zhou Cheng asked again.
"Did you apply a tourniquet?"
Zhou Cheng looked at the patient's foot. Except for the very bloody and damaged sole, it should be a girl's foot, and she should not be very old.
Then he walked to the operating table and looked around quickly, his mind racing around.
If the embolism lasts not long, the amputation can still be saved!
Amputation is the last step in orthopedics. He does not want patients to go to this step unless it is an emergency.
"The tourniquet was applied." Zhang Zhengquan hurriedly replied.
"I don't know how long it has been tied up."
"Little sister, do you know when you were admitted to the hospital?"
"Boom!~"
"Bah!~" Lying on the operating table was a young girl, who was under spinal anesthesia at the moment. She was sniffing and sobbing.
"Boom!~"
"Bah!~"
The sound of air hitting the nasal cavity and piercing the nasal mucus sounded one after another, and so on.
"Little girl?" Zhang Zhengquan asked again.
"I was admitted to the hospital at around four o'clock, doctor!"
"Bah!"
"Woo! Uh-huh.~~~" As she spoke, her body began to tremble slightly.
Both lower limbs were anesthetized, but the abdomen was still shaking slightly!
Heart of beauty in everyone!
Let alone a little girl, she has always been looking forward to growing up and wearing nice clothes and high heels...
Amputation was something she had never considered, but when she arrived at the hospital, the doctor told her that amputation was needed to save her life, and there was nothing she could do.
Her parents had argued with the doctor many times, but to no avail.
I even mentioned transferring to Shonan University Affiliated Hospital and Second Hospital, but to no avail.
There are no beds.
Now, the doctor asked again, and she could only reply like this.
Zhou Cheng looked at the time on the timing panel and saw that it had already reached 8:41. If calculated based on the time of the embolism, the embolism should have only lasted for more than four hours.
Zhou Cheng looked at the wound again, and there was looming active bleeding. Although it was not much, it also confirmed that the little girl's embolism might not be that serious.
This is not necessarily an indication for amputation?!
"Is amputation necessary?" Zhou Cheng did not dare to speak nonsense and stepped forward to lower his voice with Zhang Zhengquan.
However, when Zhou Cheng asked this question, Zhang Zhengquan thought of what Zhou Cheng wanted to do and hurriedly left the operating table for a distance, feeling that the distance was almost enough.
She approached Zhou Cheng and said in a low voice: "Brother Zhou Cheng, she jumped in line for this amputation surgery! This is also considering that she is relatively young."
"There are several emergency rooms ahead! If we need to perform limb salvage surgery, it won't be too late, right?"
Zhang Zhengquan did not say that Zhou Cheng would not be guaranteed, he just told Zhou Cheng this fact!
Um?
What's the meaning.
Zhou Cheng's expression paused and he looked at Zhang Zhengquan.
Is there a time limit for surgery?
Zhang Zhengquan saw the doubt on Zhou Cheng's face again: "Well, Director Cai and Teacher Luo have already discussed it during the ward rounds."
"Her surgery was done temporarily. The time reserved for the surgery is only half an hour!"
"Otherwise, the subsequent emergency surgery arrangements will not be successful! If the delay is too long, the lives of subsequent surgical patients may be in danger~"
"Everyone in the department is working tiredly now, and it is impossible to save this time." Zhang Zhengquan still said in a low voice.
Limb salvage and amputation!
Although the difference is only one word, the difference is actually huge.
The time cost is completely different.
After Zhou Cheng heard this, he suddenly felt a little irritable!
What the fuck?!
In this situation, if it were a normal emergency situation, he felt that with a little effort, he could save his leg!
but?
In the case of a major emergency, is it still necessary to be so cruel?
This little girl is young. According to the principle of giving priority to the elderly and children, she jumped in the queue for surgery, but the time of the surgery cannot be delayed! Otherwise, it will be unfair to the subsequent patients.
The operation time was limited, and her hope of limb salvage was completely lost!
There was hope of saving the limb, but it had to be amputated because there was not enough time.
There are many emergency patients now. If too much time is spent on her, the subsequent patients may die!
And this was when everyone from the two departments of Orthopedics was mobilized, and they didn’t say who was slacking off!
"I'll think about it again, wait a moment." Zhou Cheng forced himself to calm down.
This decision is not easy to make. If it is an elective surgery, then you can take your time and just give the patient you meet the best treatment.
But this little girl jumped in line for surgery. If too much time was spent on her, what about the patients behind her?
What if someone dies?!
That's why you die because you wasted time!
This is a decisive and cruel choice.
It must be done, and it must be done as soon as possible.
"Can't the emergency patient be transferred out?" Zhou Cheng asked Zhang Zhengquan, but Zhang Zhengquan looked confused.
"Everything is overloaded. If they can be transferred out, Teacher Cai pushed them away yesterday."
"And, last night." Zhang Zhengquan suddenly stopped mid-sentence.
"Brother Zhou Cheng, amputate your leg! Don't even think about it."
"Last night, a relative of Director Yan died because he didn't have time for surgery."
"He scolded Director Cai at that time! He said that no one had taken you out at this time!" Zhang Zhengquan said in a low voice.
"Director Yan was also furious in the department this morning."
Zhou Cheng felt a little aggrieved. He went to TM to participate in on-site first aid, and I wasn't there to play!
Can you blame me?
However, when Zhou Cheng thought about it carefully, it seemed that there was nothing wrong with Director Yan's blame.
No matter what, Zhou Cheng still occupied the quota in the department. If Zhou Cheng was not in the department, another person would come, at least there would be one more person to help!
With one more person, all possibilities will change.
However, Zhou Cheng was left at the scene, which led to the death of Director Yan's relative who did not undergo surgery in time!
Even if Zhou Cheng has a huge mission outside, he is still absent from the Orthopedics Department of the Eighth Hospital.
Although you have already reported to the hospital, everyone else from the Eighth Hospital has returned. Why don't you come back?
Are you special?
Zhou Cheng asked: "Director Yan didn't let you jump in line?"
"No. Director Yan was on the stage at that time. He thought that Director Cai could have three people doing the surgery. But as you know, a situation like yesterday's was really real."
"We couldn't arrange the manpower, so we went into shock very quickly." Zhang Zhengquan said.
Zhou Cheng took a deep breath, suppressed the fluctuations in his heart, and said: "Then let's do this, amputation!"
When he said this, Zhou Cheng's eyes were a little red.
Very reluctant to part with it!
Because of this operation, no matter how flawless the amputation is, it is a regret, and it is a regret that cannot be changed once it happens.
But there is no way!
Zhou Cheng had no right to affect the right to life of subsequent patients because of his own selfishness.
There are gains and losses. Sometimes, life is full of all kinds of regrets. The regrets in front of you are nothing compared with life!
"Okay~!" Zhang Zhengquan immediately started to move.
Then Zhou Cheng changed his clothes and went on stage.
Zhou Cheng's mastery of anatomy has reached an incredible level.
Because it was an amputation of the middle and lower part of the calf, Zhou Cheng first made an incision at the middle and lower part.
Then, he quickly found the course of the arteries and veins, and tied them firmly!
Having an artery and vein tied means that there will be no major bleeding, and it doesn't matter even if Zhang Zhengquan uses a chainsaw to play Saw.
Moreover, Zhou Cheng also made the skin incisions for Zhang Zhengquan.
Finally, I looked at the little girl's leg reluctantly and secretly said I'm sorry!
Then he turned around and said: "Quanzi, later you can start amputating the limb directly from the distal end of the artery and vein where I tied it. Just cut off the artery and vein and it will be fine!"
"For the tibial osteotomy, keep it more inward. For the other things, you should have done it many times. It doesn't matter."
"I went next door and there was a debridement surgery for an open knee injury."
Zhou Cheng is ready to go out. The amputation here is not difficult. Zhang Zhengquan can practice his hands and become familiar with anatomy.
The knee joint next door had a third-degree open injury, which obviously required more timely treatment.
Half an hour was enough for Zhang Zhengquan to amputate the leg.
Although she came to jump in the queue because she was younger and the operation time was short.
She couldn't delay the surgery.
but?
"Wait a minute!" Zhou Cheng suddenly thought of something, and then he walked to the operating room and raised his hand.
After interrupting Zhang Zhengquan, he turned back to look at him.
"You mean that in this operating room, her operation was to jump in line to perform amputation, right?"
"The time limit for the debridement of the third-degree knee injury next door should not be fixed, right?"
"So if the next surgery can be performed in the next room, can the time difference be avoided?" Zhou Cheng asked Zhang Zhengquan.
He did not participate in the surgery arrangements, so he did not know how to pick up the patient later.
"The time given by Director Cai for the knee debridement machine is more than two hours. It may be a little more. Brother Zhou Cheng?"
"You mean, the next patient will be transferred to the next door?"
"But the knee joint debridement, half an hour?" Zhang Zhengquan's eyes widened.
"That's enough! Half an hour is enough." Zhou Cheng said.
Then took a deep breath.
"If you try hard, the result will be amputation in the end."
After Zhou Cheng finished speaking, he was about to walk out, but Zhang Zhengquan ran up to catch up with Zhou Cheng and said, "Brother Zhou Cheng, you cannot arbitrarily shorten the operation time of other patients for the sake of other patients. You must also ensure the quality of the operation."
"I know."
Zhou Cheng nodded: "Quan Zi, I will go next door immediately to help Du Yanjun debridement. The operation will be completed in half an hour."
"You are here to debridement first, and you can do whatever you can. Give me half an hour, and I will come over and try to salvage the limb, and then go to the operating room next door for the next operation!" Zhou Cheng suddenly found a glimmer of hope.
Three surgeries were performed in succession, with a time difference.
Then you can maximize your benefits.
Zhang Zhengquan suddenly looked anxious when he heard this: "Brother Zhou Cheng, this isn't very good, is it?"
"In principle, open third-degree injuries of the knee joint cannot be sutured in one stage. There is nothing wrong with it."
He does not have the ability or right to decide the life or death of other people, but if he can save time, reduce the turnaround time, and save the time of this limb salvage surgery, he can fight for it!
Surgery is prioritized, and some diseases must be treated in stages, and this open injury of the knee joint is one of them!
The first stage is debridement and drainage + muscle insertion point fixation + ligament starting and ending point fixation, and the second stage is wound closure.
But this is a race against time, so we have to be fast!
The third-degree debridement of the knee joint must be completed in half an hour. When the next patient enters the operating room, it is equivalent to compressing the time of the patient next door.
"Brother Zhou Cheng, is this okay?" Zhang Zhengquan was still hesitating.
"Let's do this first, I know what I know!" Zhou Cheng took a deep breath and resolutely chose to step down.
To be honest, he made this decision with some selfish motives.
But Zhou Cheng's selfishness is not for his own honor or anything else, it's just to save a girl's leg!
If you haven't met him, it doesn't matter. If the person dies, it won't have much to do with Zhou Cheng.
But? Now that I have encountered it, what if I have the ability?
The operation of the patient next door only increases the risk of infection. This risk of infection can be eliminated through technology.
And you must be able to undergo second-stage surgery!
In this way, his financial burden was not increased, but it was just that he failed to do his best during the first operation.
Soon, Zhou Chengcheng came to the operating room next door, washed his hands and went on stage again!
After Du Yanjun saw Zhou Chenglai, his confidence instantly increased!
"Brother Zhou Cheng, how is the situation next door?" Du Yanjun asked hurriedly.
"good."
"Yan Jun, please step aside, I will do the surgery, you go to the opposite side, complete the operation as soon as possible, and then we go to the next door to help!" Zhou Cheng could only say this to Du Yanjun in order to save time.
Du Yanjun also had no doubts about him. If Zhou Cheng came again, there would be no problem for him to take the position of chief surgeon.
However, after Zhou Cheng quickly took over the operation, Du Yanjun didn't quite understand Zhou Cheng's operation process. He asked: "Brother Zhou Cheng, what did you just do? It shouldn't be to deal with the fracture first and then the soft tissue."
What?"
Zhou Cheng raised his head and glanced at Du Yanjun, and said: "Yan Jun, after today's operation is over, I will find a time to slowly review the operation process with you, but now, let's do things first, okay?"
"
Time is precious, Zhou Cheng doesn't want to waste even a moment, and it's not that he doesn't want to teach.
Rather, Zhou Cheng felt that if he had the ability to do more good things, teaching could be a back-up job.
If Du Yanjun were Xiang Haibin, he would ignore him. He is neither a friend nor a teacher. No one is responsible for teaching you anything. But Du Yanjun and he are good friends and good brothers.
Although Du Yanjun occasionally played tricks, he never played dirty tricks.
Moreover, he really helps when there is a need.
Real brothers, even real brothers, can't throw their heads and blood, so this is already very good.
If you are too harsh on your friends, it means that you don't cherish your friends first, rather than that your friends are not sincere enough!
"Okay, Brother Zhou Cheng!" Although Du Yanjun didn't know why Zhou Cheng was unwilling to speak on stage today, Zhou Cheng was usually very willing to teach.
But I just feel that Zhou Cheng is very tired. Everyone was tired all night last night, so they didn’t have much energy to distract themselves!
Then, Zhou Cheng’s hands were like flying!
The bones are broken and fixed, blood vessels are sutured, tendons are reconstructed, muscles are sutured, and there are still defects. There is no way to deal with them in the first phase. We can only perform muscle and tendon transplantation in the second phase depending on the situation!
The traveling nurse was alone, and under Zhou Cheng's high-speed operation, her hands and feet were a little numb just by holding things and driving them!
Finally, the timing panel in the operating room showed that the operation time had reached twenty-seven minutes.
Zhou Cheng felt a dull pain in the pads of his index and middle fingers!
"Step down, you send the patient to the ward, use piperacillin directly as antibiotics, and ask the pharmacy department for consultation as soon as possible to guide antibiotic treatment." Open joint injuries have a high chance of infection.
Even grade I is treated as septic arthritis, so ordinary grade antibiotics are definitely not enough!
"Get a cast across the knee joint!" Zhou Cheng explained again when he walked out of the door.
"Okay!" Du Yanjun nodded in confusion, feeling that what he had just experienced was simply too unreal.
He had the surgeon last night, but it took him almost half an hour to sew up a wound of more than ten centimeters, debridement and sutures.
Zhou Cheng, here, spent half an hour to repair the open trauma of the knee joint?
Some of the 'fancy' operations involved are extremely difficult, and one of them may take more than half an hour!
but?
all.
Even though Du Yanjun thought Zhou Cheng was already very powerful and the surgery was very fast, when he saw the result, his scalp still felt numb!
Moreover, throughout the entire operation process, quality was not sacrificed for the sake of speed. Every step was done, at least within the scope of his understanding, and it was done perfectly!
The purpose of wearing a plaster is to prevent postoperative knee joint movement, which may lead to recurrence of fractures and recurrence of rupture of the tendons that have been reconstructed!
…
"Brother Zhou Cheng, are you back?" Zhang Zhengquan asked hurriedly when Zhou Cheng walked into Room 17 again, surprised.
Zhou Cheng looked at what Zhang Zhengquan was doing and just completed a simple removal of the foreign body.
Zhou Cheng knew that there was still a big gap between Zhang Zhengquan's level and Du Yanjun's, although he had also cleaned up a small amount of blood scabs, necrotic tissue, etc.
but.
This level is actually very good. This kind of debridement of damaging injuries should not be an operation and difficulty that they should bear at their age.
"Um!"
"Thank you for your hard work, Quan Zi." Zhou Cheng slowly walked to the clothes bag and put on the sterile surgical gown.
"Brother Zhou Cheng, have you really finished the surgery next door? Is that a third-degree open injury of the knee joint?" This is the basis of orthopedics. As a regular trainee in orthopedics, Zhang Zhengquan knows this without searching for related terms.
Difficulty of surgery.
"Let's start limb salvage surgery, hurry up." Zhou Cheng was unwilling to explain too much.
It is now past nine-twenty, and this girl was admitted to the hospital at about four in the morning. If she had been tied before entering the hospital, amputation would have been inevitable.
It's a pity that she was really injured at the wrong time. At this time, it took so long.
However, Zhou Cheng still hopes to give it a try.
If he couldn't save it in the end, he would have tried his best.
Then, Zhou Cheng started vascular incision and thrombectomy.
Next to him, Zhang Zhengquan was stunned, and Zhou Chengcheng quickly took out two thrombus strips that were shaped like earthworms.
"Put on the tourniquet!" Zhou Cheng told the patrol.
"okay!"
The tour immediately followed suit.
However, it takes a certain amount of time for the pressurized gas in the tourniquet to be released, so the bleeding from the wound is still not obvious.
but!
Because the little girl had injuries, the wounds soon became soaked, and blood slowly seeped out, and soon all the wounds were reddened again.
Bleeding!
Surgeons love it.
Zhang Zhengquan widened his eyes and said, "Is there blood?"
Looking at Zhou Cheng, he was stunned!
What Director Cai, Director Yan and others couldn't do was actually in Zhou Cheng's hands, and it was so simple? How long did it take? Five or six minutes, right?
"Lift your legs!"
"Apply the tourniquet again." Zhou Cheng said hurriedly to the tour.
The cycle of the tourniquet cannot exceed one and a half hours, and then you need to rest for about fifteen minutes. The total time of this operation is less than half an hour, so there is no need to rest at all!