Start with an emergency physician
Chapter 63
When Zhou Yuan's young voice fell, the assistants who were not young also immediately perked up.
Wu Guohui was not the first time to be an assistant, but he was still a little excited.
While doing the debridement, Zhou Yuan recalled the three principles of limb replantation surgery.
First, replantation of a limb is secondary to the patient's life.
If there are other life-threatening and fatal problems at the same time as the limb is broken, these problems must be solved first, and the limb can be replanted only when life safety is guaranteed.
Secondly, if the time of separation of the limb exceeds the time limit, especially when the broken limb is rich in muscle tissue, special attention should be paid.
Because such a limb may cause fatal complications after successful replantation and restoration of blood supply to the limb. If the probability of fatal complications is too high after evaluation, amputation should be chosen.
Finally, after the limb replantation surgery, the successful survival of the limb does not mean success.
A successful limb replantation surgery must ensure that the replanted limb recovers its original function. If the function cannot be restored after the operation, it should not be replanted. Forced replantation will not only increase the patient's pain, but also make it difficult to assemble the prosthesis.
After the debridement, Zhou Yuan began to flush the vascular bed. Everything was ready, and the familiar limb replantation surgery began again.
The patient suffered a compression trauma, and the main complaint was that his right leg was accidentally caught under the car. The diagnosis was right leg compression severance, incomplete severance of the right knee joint, obvious deformity, etc.
Before starting the operation, Wu Guohui had already made up his mind that he must put on his deputy chief physician's posture in front of his leaders and junior doctors, and he must not lose face. Things like"wow" are absolutely not allowed to be said out loud.
Therefore, throughout the operation, Wu Guohui smiled and nodded slowly and regularly.
People who didn't know what was going on couldn't help but exclaimed: This is the hidden boss!
"The blood vessels have been sutured."After a long time, Zhou Yuan's words woke up the stunned people.
Wu Guohui nodded slowly: Oh, the blood vessels have been sutured.
"Not bad." Wu Guohui praised calmly
"Director Wang, please loosen the blood vessel clamp."
Now it's time to test the blood circulation function.
Director Wang did as he was told. Wu Guohui came up and was ready to find some faults for Zhou Yuan and to give everyone a warning, showing his strictness as an associate chief physician.
"Let me verify the blood circulation effect.
Zhou Yuan said"OK" and made way.
Wu Guohui touched it and said,"Well, I can feel the arterial pulsation at the distal end of the reimplanted body."
"Well... the skin of the replanted limb is ruddy, and the capillaries are filling quickly and completely."
"Hmm... the skin temperature has returned to normal."
Wu Guohui did another blood-stinging experiment and made a small cut on the tip of his finger with a thick needle. He found that blood was constantly flowing out.
Wu Guohui held up the needle and said blankly:"The anastomotic arteriovenous end is in good condition.……"
At this time, an intern who had been staring at the textbook was unhappy:"Director, why are you reading from the textbook?"
Wu Guohui:
……
The next step is to repair the muscles and tendons, and the nerves.
After completing all this, Zhou Yuan began the last step, covering the skin.
"Everyone, watch it.……"Wu Guohui couldn't help but speak
"Especially the one flipping through the books, go back and write a checkup report for the senior doctor." He said again as if holding a grudge.
Zhou Yuan was still concentrating.
The situation of the patient who was undergoing limb replantation this time was different. In order to prevent the possible annular scar contracture after surgery, Zhou Yuan made several small oblique incisions at about 60 degrees from the original wound, and then performed a"z"-shaped suture.
The patient had skin defects, so Zhou Yuan took some free skin grafts for transplantation to cover the defective part of the wound, and then placed rubber drainage strips in each fascial gap.
This is a material used to protect free blood vessels, nerves and other tissues. It is safe and convenient to use, causes little damage to tissues, and recovers quickly after surgery. It can provide good protective traction. Effect.
If the people in the operating room lived in the jungle, they would definitely be advanced humans who could eat the highest leaf.
In the conference room, the interns and trainees were staring at the screen. If it weren't for the rule that no photography was allowed, this place would have become the scene of a press conference.
In the operating room, people each have their own duties.
The chief surgeon is responsible for suturing, staying calm, and pretending to be cool.
The first and second assistants are responsible for staying calm and pretending to be cool.
The third assistant, as well as the interns and trainees are responsible for forcing themselves to stay calm.
An operation ended in a relaxed teaching atmosphere.
The moment Zhou Yuan put down the needle holder, everyone made an unsatisfied and complaining"tsk" sound.
"What, who wants to come up and break a leg to support the teaching?" Zhou Yuan glanced at the crowd and said with the momentum of a king.
"No, no"
"Dr. Zhou is awesome!"
"Director Wu?" Zhou Yuan glanced at Wu Guohui.
"No, no, no, I don’t want to either! Doctor Zhou is awesome!" Wu Guohui stared at the scalpel in Zhou Yuan’s hand that was emitting a cold glow, and trembled.
Zhou Yuan was stunned:"No, I mean, you can put down the hemostat."
Wu Guohui immediately put down the tool in his hand.
"Director Wang, do you want to announce that the operation is complete?"Zhou Yuan looked at Director Wang and asked.
Director Wang nodded.
Zhou Yuan smiled and said,"The operation is complete!"
The moment he put down the scalpel, countless interns looked over.
Under the illumination of the shadowless lamp behind him, Zhou Yuan's body radiated a circle of light.
They seemed to see a phoenix spread its wings and took off in the intern chicken coop, trampling to death countless hospitalized hens, attending roosters, and many deputy director cranes.
——
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