MTL - My Medical Skills Give Me Experiences-Chapter 410 Temper newcomers, the principle of gangrene debridement

【My medical skills can add experience points】【】

There has been no news back.

Dr. Xu returned to the operating room after going out for about half an hour to continue the operation. Not a word was said about the gangrene patient.

The teacher is the teacher, I really can hold my breath, if the matter is settled, at least give me a letter!

Zhou Can was doing surgery in the room, and didn't go out to ask more questions.

Seeing that it was almost time to get off work, Ma Xiaolan brought in a patient. It was the man whose leg wound was dehiscated and gangrenous.

This person's skin is dark, and the marks left by the sun for a long time can still be seen on the forehead, arms and other parts.

It stands to reason that this is a middle-aged male patient with a strong body and strong immunity.

Maybe it's because after the leg was injured, the nutrition could not be supplemented well, and coupled with the prolonged illness, the body had already begun to become thinner obviously. This is not a good sign.

Before his body is still in a better state, his wound must be cleaned up and the place that should be sutured should be sutured.

Then supplemented by professional medical treatment to help him recover quickly.

Any disease is as terrible as fire.

At the beginning, it may be just a spark, but if it is discovered in time, it can be easily extinguished.

The longer the delay, the worse it is.

If you wait until the fire becomes a prairie fire, it will be very difficult to extinguish it.

If you wait until the house is almost burned out, then go to put out the fire. Even if the fire was extinguished, the house would have been almost destroyed.

The same goes for treating patients.

It is necessary to stop the disease from raging before the patient's body is seriously damaged.

This is also the principle of traditional Chinese medicine to treat diseases of desire and disease.

Right now, this patient is actually on the verge of dying.

"I have already assessed his condition, and just need to perform spinal anesthesia. The prognosis may not be ideal, so let's do our part! The family members strongly demand limb salvage, and they are willing to try it no matter how much they pay. The patient himself also It is this will."

Doctor Xu walked in.

The anesthesiologist followed closely behind, also coming in with her 'treasure box'.

No wonder it took until now to send the patient into the operating room.

After Dr. Xu negotiated with his family, he probably consulted department leaders like Director Lou or Deputy Director Han. They agreed, and then applied to the Department of Anesthesiology.

Then the anesthesiology department sent an anesthetist to come over for assessment, talk to the family members and patients, and sign an anesthesia consent form.

A series of cumbersome procedures can be completed so quickly, which is already considered good.

Probably because the spinal anesthesia was performed, a female anesthetist at the attending level came in.

This level of anesthesia surgery is far from being able to dispatch a deputy director-level anesthesiologist. Anesthesiologists with high seniority and attendance level are not even required.

"Beauty, do you need my help with the waist piercing?"

Zhou Can came forward to say hello warmly.

"Okay! Director Feng's senior apprentice can help me, I wish for it!"

The female anesthesiologist squeezed out a smile at Zhou Can.

It's so rare to finally meet a normal anesthesiologist.

In Zhou Can's impression, most of the doctors in the anesthesiology department had a cold and serious face. Only the official doctor is normal.

However, since Doctor Guan almost had a medical accident that time, it seems that he has gradually become less cheerful and laughable.

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【My medical skills can add experience points】【】

There must be a reason for the lack of staff in the anesthesiology department.

There are many things, tiring work, high risks, and high pressure, and the income can only be regarded as fair.

Why is it that the income of anesthesiologists is not as high as imagined? Zhou Can heard such a thing, about seven or eight years ago, the salaries and bonuses of medical staff were restructured to a certain extent.

As a result, the nurses in one of the important departments received a bonus nearly 2,000 yuan/month higher than that of the anesthesiologists.

The anesthesiologists felt psychologically unbalanced and directly came to a collective protest.

Later, the leaders of the hospital had no choice. After a meeting and discussion, they made a rule that made people laugh and cry. The bonus of nurses can be equal to that of anesthesiologists, but not more than that of anesthesiologists.

The matter finally subsided.

If this is true, it means that the income of anesthesiologists is not as high as imagined. Otherwise, watching the nurse get an extra 2,000 yuan a month bonus would not cause such a big emotion.

The work of nurses is actually very hard.

The old fritters that don't work are not included in this list. Some lazy nurses don't bother to reach out even with a bottle of salt water, and try to make the new nurses work.

Half body anesthesia, commonly known as spinal anesthesia.

After local disinfection, puncture from the patient's waist, select the appropriate spinous process space of the lumbar spine, and inject local anesthetic into the subarachnoid space, causing the lower body sensation to disappear.

It is easy to say, but it is actually quite difficult to operate.

General novice anesthesiologists are prone to operation failure.

Zhou Can's injection skills are already at the fifth level, which is the level of the deputy chief physician. Injection involves piercing.

Zhou Can can easily operate various chest punctures, waist punctures, and abdominal punctures.

The most difficult part of this anesthesia operation is the lumbar puncture operation.

As a result, Zhou Can completed the lumbar puncture with ease, and admired the female anesthesiologist for a while.

"Do you feel anything in your lower body?"

After a while, presuming that the anesthesia had taken effect, the female anesthesiologist tested the patient's response.

"I don't feel it! It's numb!"

"That's right. It means that the waist anesthesia was successfully implemented."

The female anesthesiologist also admired Zhou Can's ability even more. For her, the piercing operation was quite difficult, and it was like playing in Zhou Can's hands. I really envied his ease of handling.

This is a performance that can only be achieved when the strength reaches a certain level.

No wonder Director Feng loves this young doctor so much!

"Hurry up and debride the wound for the patient! I don't know what's going on inside. Look at the depth, I'm afraid it has reached the bone."

Doctor Xu looked serious.

Accepting this patient was mainly because of Zhou Can's face.

Of course, Dr. Xu was also moved with compassion.

As long as doctors have a little medical ethics, they all have the same belief.

It is like the wish of a close relative, and there are not many doctors who can do this.

Zhou Can currently has level 5 debridement, which is one of the important reasons why he dared to challenge this gangrene debridement operation.

Only with diamonds can we dare to do porcelain work.

Without that strength, only a doctor's benevolence is far from enough.

"Dr. Luo, help the patient cut off those sutures first!"

Zhou Can properly gave Luo Shishen some opportunities to exercise.

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Operating on gangrene patients is a test of the doctor's psychological quality. Some people are even prone to vomiting during the operation.

Surgical masks can't stop the disgusting rancid smell.

Coupled with the visual impact, it is easy to cause the stomach to churn and spit it out.

Some novice doctors may experience serious psychological discomfort when they see dead people, **** scenes, or disgusting scenes for the first time. You may not be able to eat for a day or two.

Zhou Can followed so many chief physicians to perform surgeries, and he has done a lot of surgeries in general surgery, cardiothoracic surgery, and emergency departments, and his mental quality has been tempered early.

To say that the most psychological test may not be the operating room, but the intensive care unit of the intensive care department.

There are some patients there, such as burn patients, who are completely shattered.

There may even be phenomena such as crust melting and suppuration on the body surface.

Just looking at that makes the scalp tingle.

Let me say here that scab melting will not only bring great pain to the patient, but also be very dangerous.

In particular, large areas of scabs must be prevented in a timely manner.

"I…"

Luo Shigen frowned tightly, wearing gloves, holding the scissors Qiao Yu handed him, as if forcing him to jump into a fire pit.

"Hurry up, don't grind!"

Zhou Can urged impatiently.

Luo Shishen is his subordinate now, if there is a problem, he will definitely supervise it.

Doctor Xu doesn't care about such things at all.

Qiao Yu had worked as a nurse in the intensive care unit, so she had a strong psychological quality, and only needed to pass the equipment, but she took it lightly. Ma Xiaolan seemed to be a little bit unable to bear this disgusting scene. She stood under the stage, not even daring to look at the patient's wound.

The condition of the operating room itself was also not good.

If it is a laminar flow operating room, even if it is a 10,000-level laminar flow operating room, it can absorb and discharge the odor around the operating table.

Now, everyone will enjoy the rancid smell.

"This, there are so many sutures! Isn't it torturing people!" Luo Shishen's hands were trembling, and if he was not wearing a mask during the operation, he could definitely see his disgusted expression.

"Concentrate."

Zhou Can shouted again.

In this case, as a senior doctor, you must be strict.

Under his deterrence, Luo Shishen could help offset part of his inner discomfort.

The removal of sutures is generally a knot and a knife.

If it is a coherent suture method, only one knife can be cut when removing the stitches. However, under normal circumstances, the nurse will cut each suture once when removing the stitches.

Because the suture can be pulled out from the patient's cortex with less effort.

Under Zhou Can's oppression, Luo Shishen cut off the sutures one by one and cleaned them up.

Without the sutures, the patient's wounds were even more open.

Pus mixed with blood dripped down like saliva.

The rancid smell became more pungent and rich.

"Xiaolan, don't stand still, catch it with the trash can."

Zhou Can is a rookie who intends to train the surgery team.

Under normal circumstances, the seniority of the itinerant nurse may be older than that of the chief surgeon, and there is no need to call at all.

Ma Xiaolan came over to catch it with a trash can, turned her head, and seemed to be holding her breath.

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【My medical skills can add experience points】【】

"Watch it, don't let it leak on the floor. It will be a hassle to clean up."

There are countless bacteria and even viruses in this pus.

Cleaning and disinfection are by no means an easy task.

"vomit…"

Ma Xiaolan began to retch, then covered her mouth and ran to the covered trash can.

Doctor Xu shook his head repeatedly.

But he didn't say anything.

After all, they are all newcomers.

Maybe some emotions are really contagious. For example, yawning. When we see others yawning, we can't help but have the urge to yawn.

At this moment, Ma Xiaolan's vomiting seemed to have infected Luo Shishen as well.

A big old man actually followed the past and vomited.

"As far as this psychological quality is concerned, you have to exercise hard."

In order not to delay the operation process, Zhou Can removed the stitches himself. It's just a small job, and it's not difficult as long as you can overcome your inner fear and discomfort.

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All sutures were quickly removed.

"Give me the suction head and let me **** up the blood and pus inside."

Zhou Can said to Qiao Yu.

"Give!"

Qiao Yu had already prepared it and handed it to him immediately.

Originally, the work of sucking blood and pus should be done by medical assistants.

Zhou Can took care of Luo Shishen's discomfort, so he had to do it himself.

"Let me do it!"

As a teacher, Dr. Xu has seen all kinds of scenes. With a calm face, he became Zhou Can's assistant.

After Luo Shishen and Ma Xiaolan finished vomiting, they looked very embarrassed.

Ma Xiaolan burst into tears.

It really hurts when you vomit.

"You two just watch from the sidelines! You must learn to adapt and adjust. In the future, follow me for surgery, and you will definitely see bigger scenes."

Zhou Can made a request to the two of them.

The patient looked embarrassed and simply closed his eyes.

It would be better if I knew earlier that general anesthesia should be given to the patient.

After cleaning up the blood and pus accumulated inside, Zhou Can began to prepare for the patient's wound debridement. The meat in many places has been completely rotten.

"Xiao Zhou, tell me about your idea of ​​debridement."

The meaning of what Dr. Xu said was to tell Zhou Can not to use the knife in a hurry.

"The gangrene of this patient belongs to wet gangrene, and the wound surface is deep or shallow. I plan to debride the wound in stages and batches. Today, the tissue that has been clearly necrotic is debrided in time. For unclear boundaries, it is difficult to determine whether it is completely necrotic. The organization is temporarily reserved."

Zhou Can gave his own surgical ideas.

Many surgeons take it for granted that when debridement is performed on patients with gangrene, they must cut to the end and remove as much junctional tissue as possible. Even the normal tissue section ~www.novelbuddy.com~ is cleaned up a bit more.

In fact, this idea is wrong.

If you do this, it is likely to aggravate the condition.

When debridement of patients with wet gangrene, as Zhou Can did, as much normal tissue as possible should be preserved. There must be no haste.

If you can't eat hot tofu in a hurry, it is also suitable for use in surgery.

Clean up all the rotting tissues at one time, even including some normal tissues, to keep the wound clean. I thought, if the wound is cleaned up this time, it will definitely heal.

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【My medical skills can add experience points】【】

That's just wishful thinking among the new Cradle Doctors.

A surgeon with rich experience will definitely follow Zhou Can's thinking.

"You have a very good idea, let's start cleaning up!"

After hearing this, Dr. Xu not only appreciated Zhou Can even more, but also let him operate with confidence.

Zhou Can first cleaned up the obviously necrotic tissues.

Then perform preliminary cleaning on the wound, and begin to carefully identify which places should be left and which should be removed.

This process is far more difficult than imagined.

It is a test of the patience and care of the doctor involved, and it also has certain requirements for the knife technique. Some parts are simply cut off with scissors.

…

After more than three hours, Zhou Can looked at the patient's wound with a satisfied expression.

The wound that was full of pus before has changed its appearance and has a new look.

Stop the bleeding where it should.

The obvious pus and carrion are basically invisible.