Chapter 367: Not serving everyone! (Please subscribe!)
Lu Cheng is still continuing the operation meticulously. Now, although his professional title is only that of attending physician, he has long been authorized to perform various surgeries, including new surgeries, and can perform them regularly, as long as there are suitable diseases.
exist.
Replantation of severed limbs is generally aimed at severed limbs with relatively smooth ends.
The amputated limb transplant performed in Chang City is aimed at people who must have their limbs amputated for life-saving reasons, and then transplant the amputated limbs. The target is those who suffer from severe ischemia for a period of time after amputation.
patients.
If this can be developed successfully, it can reduce the disability of many patients.
A lower-level hospital may not be able to save a limb, but it can save a life by amputation. Then after the vital signs are stable, the amputated limbs will be sent to a higher-level hospital together. This is equivalent to dismantling the operation!
The time window for surgery is delayed.
However, what Lu Cheng is doing now is the reconstruction of amputated limbs after damage. This is another level of theory. Is it more suitable for segmental damage, other locations besides stages, or
OK.
Under such circumstances, it is necessary to reconstruct the tissue of the damaged segment and restore the normal length of the patient's limb.
This kind of operation will be more difficult. It is considered as waste reuse, and it also involves dismantling and repairing, and extending the length of the originally normal muscle tissue through various methods such as thinning and splitting!
What is more difficult to deal with is the vascular nerves. The vascular nerve tissue cannot be divided into bundles, so it can only be replaced by nerve branches of other normally shaped nerves, but whose relative function and nutrition are not important...
It sounds simple, but it actually involves a lot of high-end surgeries.
For example, just for a muscle, there are muscle transplantation, muscle replantation, muscle repair, myoplasty, tendon transplantation, tendon replantation, tendon plasty, tendon transposition, tendon repair, tendon suturing...
Among them, the difficulty of tendon suturing is relatively simple!
In addition to muscles, there are also blood vessel transposition, blood vessel suturing, blood vessel repair and shearing, blood vessel transplantation...
Guang Yanhu was already fascinated by what he saw.
When this patient comes, the instinctive reaction of all doctors, especially trauma surgeons, is how to save the limb. Is the risk high?
After Guang Yanhu looked at it, he just decided to save this side of the foot, and the other side was best treated by amputation. The possibility of saving it was too small.
However, in fact, Guangyanhu also knew that it was theoretically possible to save the leg, but it would cost a lot. For example, Ding Changle and other orthopedic professors all appeared during the operation.
between.
It is insurable, but the timing is not a coincidence.
Not to mention other professors, even the people in the trauma surgery department need to get out more.
For the 22 rooms next door, Cai Dongfan forcibly sent Jin Ping to deal with it temporarily, and then kept him Guang Yanhu, giving this young man priority to deal with it.
However, after this young man's luck was completely unlucky, he ushered in the greatest turning point!
It happened to be New Year's Day, and Zhou Cheng came to Shashi to celebrate the festival. The skills Zhou Cheng has shown now can at least be used by three professors. This is not bragging.
Of course, it's not that Zhou Cheng has three professors who are great, but Zhou Chenghui's technology is simply too comprehensive. You said bone splicing is only that good, so forget it. You are so good at suturing, and your sutures are of such high quality.
, forget it.
How come you can sew muscles and blood vessels so well when there is no place to place microscopic instruments?
…
Two hours later.
The debridement on Guang Yanhu's side has almost come to an end.
According to the previous arrangement, Guangyanhu had to go to room 22 first to check the situation.
However, Guangyanhu, who had finished his surgery, did not go next door. Instead, he sent Zhu Pei who was following him and went to room 22 next door to take a look first. He, on the other hand, got closer to Zhou Cheng and arrived at Zhou Cheng.
Opposite the patient, he personally participated in the operation and observed and learned.
When you look at it from a distance, you just see the process, but when you look at the details up close, you realize that Zhou Cheng's detailed operations are unimaginable by ordinary people, and his fingers fly gracefully like a swimming dragon.
However, Guangyanhu still noticed that Zhou Cheng's fingers seemed to be a little stiff and trembling slightly. It should be that he had been moving quickly for too long in a short period of time, which caused muscle fatigue and lactic acid accumulation!
Looking at the progress of the operation, Zhou Cheng has clearly completed most of the operations. All that is left now is the suturing of the outermost muscle layer. Zhou Chengdu has even layered and paved the muscle tissue.
Guang Yanhu stretched out his hand and whispered: "Xiao Zhou, I will do the rest of the sutures. Can you rest for a while? Are you watching from the side?"
Four hours have passed since Zhou Cheng woke up. After such a long time, the machines should be red from friction, let alone people?
The duration of Guang Yanhu's surgery was the same as that of Zhou Cheng, but the degree of fatigue was completely different when doing different things.
Zhou Cheng glanced at Guang Yanhu, hesitated for a moment, and handed the equipment in his hand to Guang Yanhu. He also changed positions back to back with Guang Yanhu, who had already prepared to replace him.
When making a fist, Zhou Cheng clearly felt that the flexor tendons in his hand were constantly trembling. The pain caused by fibrillation made it difficult to exert force, but Zhou Cheng still insisted on holding it, but his left and right hands were constantly rotating, and then he used another hand.
One hand kept stretching and contracting, making relief movements.
Only then did Cai Dongfan notice Zhou Cheng's condition. He thought for a moment and said, "Xiao Zhou, you and Professor Guang will do the rest of the surgery together. After you're done, you can get off the stage and go back. I'll go check on the situation next door first."
.”
Zhou Cheng raised his head and glanced at Cai Dongfan again, and whispered: "Master, I just need to take a rest. I will go back after the operation in the next room is over. It's time anyway."
The surgical patients in Room 22 were specially greeted by general surgeons, but Cai Dongfan ignored them. If any problems occurred later, it would not be conducive to Cai Dongfan's efforts to unite his colleagues in the hospital.
"Okay." Cai Dongfan took off his clothes and continued walking to the operating room next door.
After leaving the operating room, on the operating table, several professors from other departments started talking: "Xiao Zhou, please add me to WeChat later and I can introduce you to some girls."
"Hey, Professor Ning, your introduction to girls is just a pretense. You need WeChat to be real. Someone else, Xiao Zhou, already has a girlfriend. Xiao Zhou, don't add him, add me. I know there are many gyms in places where you can
Discount."
"Furthermore, I have a half-month experience card for the gym near the hospital. You can try it in turn. As long as you don't go very frequently, you probably won't need to apply for a card in a year or two, and you'll be using the gym in vain."
"Who are you? You are disrespectful. Xiao Zhou, let's add a WeChat account later so that I can call you when we hold an academic conference in the Department of Surgery..."
Hearing this, Zhou Cheng raised his head and smiled at everyone, nodded and said yes, and also said thank you to all the teachers.
Then when he focused his attention on the operating table, Guangyan Hu whispered: "These professors are seeing your strength. If they encounter difficult patients in the future, they hope to find you to treat them."
"Most of the severe emergencies encountered by the Shonan University Affiliated Hospital are fatal. If we occasionally encounter difficult emergency patients, the chief resident on duty will not be able to do enough, so he will call for help privately."
"This is also a manifestation of personal connections. Of course, the stepping stone is that you have to be recognized first."
When Guangyan Hu said this, he opened his eyes and continued to educate Zhou Cheng: "After adding WeChat later, be sure to note the department and name in detail, otherwise, you will definitely be confused in the future."
"And when you go to work, these professors will also be your best working partners. It can be said that the more professors you know from other departments, the better your work will be."
Zhou Cheng nodded thoughtfully.
"Thank you Professor Guang."
Birds of a feather flock together.
Even in such a top hospital, there are different circles. There is a group between residents and graduates. There is a group between graduate students. There is a network between doctors and doctors, attending consultations, and associate professors discussing how to be promoted to professors.
, enjoy life.
The professors are thinking more about how to ensure that the patients in their own department can truly survive, and what channels and resources can be used to solve various complications!
"In real clinical practice, no patient will fall ill according to the textbook, nor will it just be a simple disease. At this time, consultation is very important. Especially consultation in some internal medicine departments."
"Also, the connections of the anesthesiology department are the most fundamental foundation of a surgeon. What kind of patient, what kind of anesthesiologist dares to operate, and what kind of patient, the anesthesiology department does not dare to operate. It depends on the individual!"
Guangyanhu continued.
However, while Guang Yanhu was talking, he saw that Zhou Cheng pulled out the unknotted threads that he had just stitched, and then used tweezers to rearrange them, exposing the layers of Guang Yanhu's stitches.
It was too deep and a small artery was pierced.
"Thank you Professor Guang for your advice." Zhou Cheng's tone was still sincere, and he did not start to play tricks just because he had just corrected Guang Yanhu's mistake.
Guangyanhu was actually a little embarrassed, and Guangyanhu also saw that Zhu Pei next to Zhou Cheng had a shocked look in his eyes, as if he couldn't believe it at all, Zhou Cheng dared to pull Guangyanhu's sutures.
, and it is even more unimaginable that Guangyan Hu, the technical person in the team, would also make mistakes.
Guangyanhu blushed even more embarrassedly.
Taking a deep breath, I continued to stitch, but with more concentration.
More than forty minutes later, Guangyanhu looked at his wound, raised his head and asked, "Xiao Zhou, is this no problem?"
Asking this question is like a student.
During the entire suturing process, Zhou Cheng corrected his mistakes three times. The second time was due to his carelessness, but the third time, Guangyan Hu really didn't expect that Zhou Cheng could notice the blood vessels that were not much bigger than a hair.
cavity!
"It should be fine for the time being." Zhou Cheng felt that the dorsalis pedis artery was beating normally and breathed a sigh of relief slowly.
"VAC coverage, skin grafting can only wait for the second phase. For this patient, the bacterial culture results must be followed up every day after the operation, and the antibiotics should be adjusted at any time. After returning home, he will use Wangu once, and piperacillin will be used as a regular antibacterial agent, and cephalosporins will be used temporarily.
No."
If such a patient does not use enough antibiotics in the early stage, and if infection occurs and the soft tissue emulsifies, there will be no chance of limb salvage next time.
At this time, the dosage and level of antibiotics must be higher.
Guang Yanhu did not express disagreement, but just explained: "Vancomycin intravenous medication can only be prescribed with Professor Cai's work number. After prescribing, please immediately ask the pharmacy department for consultation, explain the situation, and let the pharmacy department make up for the consultation."
Opinion!"
"Okay, Professor Guang." Nazhubei nodded hurriedly.
After Zhou Cheng and Guang Yanhu finished applying the VAC, they left the stage first, and then left Zhu Pei here to temporarily watch the VAC negative pressure suck blood.
However, although the orthopedic surgery is over, the general surgery is not. Therefore, the professors who were clamoring for Zhou Cheng's contact information are now concentrating on the surgery and are not distracted by Zhou Cheng's resignation.
.
Zhou Cheng took another look and found that there was nothing dangerous about the patient, and then he slowly breathed a sigh of relief.
Fortunately, some of the difficulties have been overcome. I hope that everything will be fine and he can wake up regularly without getting infected. Then this child can be saved.
If it is an infection or other accident, then there is really nothing you can do.
When manpower is limited!
All that's left is to pray.
Then, Zhou Cheng came to Room 22. However, as soon as he entered, Zhou Cheng found that the smell in the operating room was a bit wrong.
"Professor Cai, where are your people from the Department of Orthopedics? Haven't they come here yet?" This was a voice urging him.
"Aren't we orthopedics? When will there be no orthopedics for this surgery?"
"I'm talking about Zhou Cheng, Professor Cai, please don't make things difficult for me. What's going on now? How long has it been? Can you still save your leg?" His tone was a little yin and yang.
"Zhou Cheng is not a formal employee of our orthopedics department yet." Cai Dongfan's tone was calm and he did not take the other party's words seriously at all.
"Then I heard that he operated in operating room 21 before?" The voice of the man wearing sterile surgical gown was slightly stagnant.
"The condition in the operating room next door is even more serious!" Cai Dongfan's face dropped.
"I also heard that the operating room next door is a relative of Professor Cai?" Another voice said even more unbelievingly.
"Professor Chang, do you want me to bring you the family tree to check?" Cai Dongfan said, getting really impatient.
Professor Chang also looked coldly and began to look serious: "Professor Cai, this is a patient of your orthopedics department anyway, and it is also your orthopedics department's business. You can just take full responsibility."
Chang Lilong knew that Cai Dongfan didn't take his greeting seriously at all, which made him very unhappy, but it was not easy to get angry.
"Otherwise, Professor Chang, you should still be responsible?" Cai Dongfan asked with a serious face.
When Zhou Cheng heard this, he walked out of the operating room very decisively and went downstairs!
He is not a bitch, and he does not serve everyone.