My Medical Skills Give Me Experiences
Chapter 481: Earn 1 wave of extraskeletal experience points, level 6 incision
Chapter 481 Earning a Wave of Extraskeletal Experience Points, Level 6 Incision
After the chest wound was opened, the remaining sternum was clearly infected and discolored.
As osteomyelitis progresses, eventually bone necrosis occurs.
The incidence of this disease is extremely low.
In particular, hematogenous osteomyelitis is very rare and belongs to a very difficult disease in the field of orthopedics.
Infection after sternal surgery is a common cause of this disease.
Zhou Can removed all the sternum, completed debridement, and then took a rib from the left and right sides to reconstruct the chest wall.
It is two ribs placed across the ribcage.
【Experience value of osteosynthesis +1, bonus experience value of osteosynthesis +100. 】
One hundred experience points is not much reward for such a difficult bone joint.
However, compared to only earning 1 point of bone fracture joint experience at a time, this is already a rocket-like improvement speed.
At present, his osteosynthesis is still at the fourth level, which is the attending level.
If you want to be promoted to deputy director, you have to work harder.
Mainly for surgery, there are very few orthopedic patients. He can't handle the difficult ones, and can't earn much experience points if it's easy.
There is no way to do this, we can only accumulate bit by bit, accumulating steadily.
For almost all surgical techniques, level 4 and level 5 are an important watershed. Before the fifth level, it can only be slowly boiled.
Basically all surgeons have survived a little bit like this.
Promoted to the fifth level, that is, the level of the deputy chief physician is considered to be over the top. At this time, I can already participate in various major operations, and I have the ability to try to complete some difficult orthopedic operations.
Although orthopedic surgery only treats a few bones, orthopedic surgery is known as the most profitable department in surgery, and its weight can be imagined.
Even if you just master surgery, you can do well.
In fact, hand surgery, foot surgery, joint surgery, lumbar spine surgery, orthopedic trauma surgery... if you master any one of orthopedic surgery, you can become an orthopedic surgery expert that major hospitals are rushing to hire.
Income and status will be very good.
Because Huaxia has a long history of Chinese medicine, the ancient medical skills and martial arts are actually not very separated. Especially bruises, internal injuries, and external injuries are closely related to those who practice martial arts.
Ordinary people are generally sick, only those who practice martial arts like to fight and kill, and getting injured is almost a common occurrence.
Broken hands and feet, or broken ribs, all of these need to be treated by Chinese medicine.
Therefore, traditional Chinese medicine treats orthopedic injuries. Even today, when modern western medicine is in full swing, traditional Chinese medicine orthopedics is still unique and stands out from the crowd.
Which one is better in bone setting reduction?
It must be Chinese medicine!
For sprains and fractures, you have to be a doctor of traditional Chinese medicine.
The most common method of Western medicine to treat fractures is to drill steel nails. A splint is placed, and a dozen or twenty steel nails can be attached. Not to mention the terrible cost, the patient's bones will also be drilled and riddled with holes.
Of course, regardless of Chinese medicine or Western medicine these days, a good doctor is one who can restore patients to health.
Western medicine is not useless in the field of orthopedic surgery.
For the correction of deformed bones, the traction of traditional Chinese medicine can be useful, but the effect is far worse than that of western medicine.
For example, for severe scoliosis, there is almost nothing Chinese medicine can do. Western medicine can directly perform surgery, cut off one or two vertebrae, and then supplement with necessary exercises, so that the patient can finally become a normal person who can straighten his waist.
In addition, the treatment of bone cancer is also dominated by Western medicine.
After Zhou Can reconstructed the sternum for this patient, he quickly freed the bilateral pectoralis major muscle flaps.
What are you doing?
These muscle **** were filled to the sternum defect, and then the pectoralis major muscles on both sides were sutured together to achieve the purpose of reconstructing soft tissue.
After all this was done, a drainage tube was placed in the chest wall incision, the closed cavity was sutured, and the operation was finally complete.
Zhou Can let out a long breath of foul air.
Doing this operation brought him a wealth of medical experience. In addition to the experience value of osteosynthesis, there are also experience points of medical techniques such as incision, suture, hemostasis, and anastomosis.
Whether it is resection of the sternum, or free pectoralis major muscle flap to fill the lack of pectoralis, this is an absolute technical work.
It is of great benefit to his own surgical growth.
"Okay, as long as the patient is treated with antibiotics after the operation, he should be able to recover quickly. If there is another infection this time, it will be troublesome, and there is basically no solution."
Zhou Can added a sentence later, which is to remind Director Xueyan to strengthen the postoperative care of patients.
For a bad patient who enters the palace for the second time, the opportunity for surgery is one less.
Thoracotomy is extremely harmful to the patient.
Now the sternum is completely removed, and two ribs are taken to rebuild the chest wall, which has basically consumed the last bit of the patient's "property". If there is another infection, it will really be the end of the mountain, and there is a high probability of death.
If this patient is cured, it will be of great publicity significance.
I believe Director Xueyan must be able to distinguish the seriousness from the seriousness.
The second operation was a lung cancer surgery patient.
This person had a lobectomy three months ago at Fangxin Cancer Hospital.
This time it was a postoperative recurrence, accompanied by distant hematogenous metastasis.
The metastatic locations that have been identified so far include hilar and mediastinal lymph nodes.
Such extensive metastases have actually been difficult to resolve through surgery. To put it bluntly, there is little point in doing surgery again.
It's just that the patient is in his prime, and his wife, children, and parents all have a strong willingness to treat. Even if it means going bankrupt, he is willing to give it a go.
Facing the strong willingness of the family members for treatment, Deputy Director He was deeply moved and finally decided to accept the operation.
Deputy Director He knew that his surgical skills were limited, and he had to rely on Zhou Can to have a chance to crack such a hard bone. So after discussing with directors Zhou Can and Xueyan, the surgery date was set tonight.
One thing is particularly interesting. The Third Hospital poached so many key doctors and nurses from Tuya's cardiothoracic surgery last time, but Deputy Director He was not poached.
This surprised both Zhou Can and Director Xueyan.
You know, Deputy Director He has always been a thorough egoist. Even if he bowed his head to Director Xueyan and no longer competed for the position of department director, he still behaved quite selfishly at work.
According to common sense, such a person can basically be found at a glance.
However, the Third Hospital failed to poach him.
Afterwards, Zhou Can heard that many doctors in the Department of Cardiothoracic Surgery resigned one after another. On the second day, Deputy Director He became very irritable and irritable, and broke several cups in the office.
No one knew exactly why he was angry.
It may be that many extrathoracic doctors were poached away, which greatly increased his work pressure. It may also be because a large number of backbones resigned collectively, including some backbone doctors he personally trained, which made him feel angry.
But there is another version.
According to rumors, the Third Hospital poached a deputy chief physician under him and offered him an annual salary of 700,000 yuan, after tax. In addition, Vice President Zhang of the Third Hospital personally came forward to dig people out.
The price offered by the Third Hospital to Deputy Director He was only 600,000 yuan, and it didn't say whether it was after tax or before tax. Moreover, it was only a department-level cadre from the Third Hospital who came forward to dig him out.
The salary is obviously lower than that of the deputy chief physician.
Isn't this slapping Deputy Director He in the face?
It is estimated that the truth of the latter rumor is quite high. Otherwise, with Deputy Director He's personality, the possibility of job hopping is extremely high.
Of course, this kind of thing is not confirmed by myself, and no one knows whether it is true or not.
For Tuya Hospital, whether it is true or not, it is an indisputable fact that Deputy Director He has worked harder since a large number of key doctors and nurses in the department were poached. Hospitals and cardiothoracic surgery departments have benefited accordingly.
"Doctor Zhou, this patient's mediastinal lymph nodes have been dissected and the right lung lobe has been resected. I'm afraid I have to ask you to perform the surgery."
After the second patient was sent to the operating room, Deputy Director He arrived soon.
Director Xueyan led the team to perform another cardiac surgery. Her current surgical ability is already very strong, and it is enough for Zhou Can to support her in the same operating room.
For her, Zhou Can's role in the operation is more often to wipe her buttocks.
When an emergency happened, Zhou Can quickly rescued him.
To put it more clearly, Zhou Can is equivalent to playing the role of Director Hu before.
"No problem, as long as you guide me in the operation. We young people should work harder."
Even now, Zhou Can has a good relationship with Deputy Director He.
But a villain will always be a villain.
He never changed his view of Deputy Director He because of his friendly attitude, or even trying to curry favor with him. When getting along, he has always been extremely humble and careful in front of Deputy Director He.
Speak as little as possible and do as much as possible, so as not to arouse Deputy Director He's resentment.
People eat whole grains, and one kind of rice feeds all kinds of people.
A department can have as few as dozens of people, as many as one or two hundred people, or even more.
It is impossible to ask everyone to be a gentleman, and everyone to be a friendly and kind person.
Everyone has it.
Learn to unite these people, and then gather everyone's strength together to do a good job in the department's diagnosis and treatment business. This is the mind, tolerance, and management ability that a manager should have.
In the past year or so, Zhou Can's ability in management has improved significantly.
This also laid a certain foundation for him to lead a larger surgical team in the future, to be promoted to the director of the department, and even the vice president and dean.
Surgery will begin soon.
After opening the patient's chest, he found that the actual situation was more serious than the pictures taken.
Some tumors that are too small in diameter cannot be scanned even with sophisticated instruments. It can only be seen with the naked eye if the chest or abdominal cavity is opened.
"His cancer cells have metastasized and spread, it's far worse than imagined!"
Zhou Can looked at the patient's right lung, surrounding tissues, and mediastinal lymph. Based on experience, this was the result of severe infiltration of cancer cells.
Surgeons who have done anatomy know very well that malignant tumors are often oddly shaped and poorly colored. Benign tumors are well-defined and well-defined in shape.
Just like poisonous mushrooms are often colorful and can be seen at a glance.
Of course, some poisonous mushrooms look simple and clean, but they are still poisonous.
Some malignant tumors may also resemble benign tumors in appearance, which is difficult to judge with the naked eye.
This is why doctors never judge whether a tumor is good or bad after cutting it out, but send it directly for pathological examination.
In many cases, it is still an intraoperative examination.
This generally requires contact with the pathology department before the operation, and then when the operation is performed, the excised tissue should be sent for examination urgently to get the results quickly. It is benign and can be removed normally.
If it is malignant, extended resection must be done, and even further lymph nodes need to be searched and dissected.
"I'm afraid I'll have to wear magnifying glasses."
When the itinerant nurse heard this, she quickly took a pair of magnifying glasses and put them on for him.
"How are you wearing it?"
The traveling nurse was quite gentle with him.
"Teacher Chang's glasses are first-rate, just right. It's just that I'm not used to wearing them. Everything looks big, like I've entered a kingdom of giants."
Zhou Can's words made everyone laugh.
He wanted to liven up the atmosphere in the operating room.
There is a tough battle to be fought next, and if the operation can be completed before twelve o'clock, it will be regarded as a high incense.
Fortunately, he is young, and his physical strength and energy are at their peak, otherwise it would be too much for him.
No wonder many people say that the peak age of a surgeon is before the age of thirty-five. After the age of thirty-five, basically you can only slowly retreat to the second line and start to lead apprentices.
The general operation part is completed by the apprentice, and the key part is performed by himself.
"Scissors!"
Zhou Can took the scissors from the equipment nurse and cut the mediastinal pleura under the azygos arch. At this time, the diaphragmatic nerve could already be seen.
Cut along the back of the septal nerve to the front of the hilum.
Then the phrenic nerve cuff was carefully retracted, and then the fatty tissue and lymph nodes were cleaned from the pericardium to the lung...
It is easy to say, but every step of the operation needs to be careful.
Even though he knew Zhou Can's surgical skills were extraordinary, Deputy Director He still watched nervously. At the same time, he helped Zhou Can do some assistance.
Whenever some key parts, important organs, nerves, and blood vessels are involved, Deputy Director He can't help shouting, be careful, be careful.
There are too many metastatic cancer cells.
Through magnifying glasses, he can clearly see some pimple-like particles.
Those are not ordinary particles, but cancerous tissues that each have the potential to rapidly grow into huge malignant tumors.
Zhou Can carefully cleaned the cancerous tissues and lymph nodes one by one.
His incision and separation experience points have been continuously increasing.
Because the operation was performed on an important location such as the pericardium, UU Reading www.uukanshu.com experience rewards also made him soft.
[Incision experience value +1, complete difficult resection, reward incision experience value +100. 】
[Incision experience value +1, complete difficult resection, reward incision experience value +100. 】
…
[Congratulations on your incision technique being promoted to level six. 】
This time I helped Deputy Director He perform this ultra-difficult cancerous tissue removal operation, and I really made a lot of money.
Especially his incision and separation techniques made a lot of money.
You know, it takes a full hundred thousand experience points to advance from level five to level six. Although Zhou Can frantically performs surgeries in the emergency department every day, he still has not been able to upgrade.
This time he accidentally earned a large amount of incision experience rewards, and was finally able to successfully advance to the sixth level, reaching the level of a director.
Incision in surgery is actually equivalent to basic anatomy.
Separation is an advanced medical technique in anatomy.
In ancient times, Paoding Jieniu practiced the basic anatomy to the extreme. It can easily complete the dissection and deboning of a cow.
Zhou Can's incision technique has been promoted to the director level, which means that his ability to dissect the human body has reached an extremely high level. He can easily dissect any part of the human body like a paoding dissolving an ox.
In addition, when he cuts any tissue part of the body, the feedback is also clearer.
It seems that there are countless probes on the palm, which can highly identify the feedback signals of scalpels and various instruments. Sensitivity is not the same as before.
Now, let him cut a stack of thick A4 paper, he is already sure to cut as many layers as he wants. Previous Chapter Contents Bookmarks Next Chapter
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