The main reason for Sun Li's surprise was the duration of necrotizing fasciitis.

Necrotizing fasciitis is a disease that develops extremely quickly. If it occurs in the extremities, necrotizing fasciitis usually affects the entire limb in about 24 hours. When it occurs around the anus or on the posterior peritoneal wall, it progresses even faster than it occurs on the limbs.

But three hours...... Will it develop to this point in three hours? Sun Lien watched in disbelief as Dr. Wang performed the drainage operation. A large amount of fishy, purplish-red liquid continued to emerge from the wound under the rinse of saline and hydrogen peroxide. And there is a tendency to take more and more risks.

"It's necrotizing fasciitis. Doctor Wang continued the operation on hand, "Doctor Sun, you are in charge of the internal medicine treatment, and I don't have the energy to be distracted now." ”

It is no wonder that Dr. Wang made this request, and in order to make the irrigation more thorough, he has made five incisions around the right side of the anus. After bluntly separating the adipose tissue from the necrotic fascia through a hemostat, he also needed to perform tissue forceps to pull the necrotic fascia out – there were many operations, but there was only one anesthesiologist in the dressing room.

In principle, an anesthesiologist is not even required for incision and drainage of a perianal abscess, and surgery can be performed after local anesthesia is completed with lidocaine infiltration injection. If it weren't for the patient's strong request, Dr. Wang would not have asked an anesthesiologist to administer spinal anesthesia to him.

Although he could not understand Chinese, the frequency of the doctors' communication suddenly increased, and the peacekeeper from Nigeria could guess that something was wrong with his situation. The anesthesiologist soon noticed that his heart rate and blood pressure were rising rapidly. Verbal comfort did not yield the desired effect, and the anesthesiologist directly anesthetized the patient with 5% glucose-diluted propofol injection after seeking the consent of Dr. Wang of the Chief Surgeon.

"Nurse Tian, let the operating room prepare. Dr. Wang continued to operate, but the movements of his hands were getting faster and faster, "This operation has to be transferred to that side - something will happen if it continues like this." ”

Sun Lien gave an anti-infective treatment plan in internal medicine, "Penicillin G skin test, after confirming that there is no allergy, 2 million units of intravenous infusion, four times a day. He took another look at the patient's status bar and maintained his judgment after making sure there were no meningitis and endocarditis caused by Streptococcus pyogenes. "Dr. Wang, how big is the extent of fasciitis?"

Dr. Wang finished cleaning one side, and then directly cut the patient's other anal perianal area, "This knife will probably know...... the groove. He burst into a foul mouth, "On both sides?!"

On the other side, pus and purplish-red fluid gushed out from the perianal area. It's just that the amount is a little less than the other side.

"The superficial fascia of the gluteus maximus on both sides are all necrotic. After three more debridements near the perianal area on the other side, Dr. Wang muttered, "The deep fascia has been affected, and the perineal fascia is estimated to be enough to choke ......" He sighed deeply, "This is troublesome." ”

After five knives, a total of more than 1,000ml of liquefied necrotic tissue gushed out. The skin of the black soldier is already very dark, and it is indeed not easy to see the red and swollen skin. However, it was obviously a necrotizing fasciitis, but it was treated as a perianal abscess. This makes Dr. Wang feel very embarrassed now—especially with a Sun Lien standing next to him.

Under the notice of Nurse Tian, the operating room quickly completed comprehensive preparations. The Nigerian soldier, who had been stabbed five times in the buttocks and looked like he was going to have another five stabs, was quickly transferred to the operating room.

"What's the situation?" Chen Tianyang also appeared in the operating room, and he looked fully armed. "I just heard your little nurse outside say that something went wrong with the operation?"

Although his face was covered with a mask, Sun Lien seemed to be able to feel Dr. Wang's hot face from a few meters away. Out of "humanitarian concern" for his peers, he quickly explained, "The patient's condition progressed rapidly within a few hours, and Dr. Wang found that the perianal abscess had progressed to perianal necrotizing fasciitis when he operated on the operation. ”

In fact, according to the prompt in the status bar, this is the situation that is closest to the truth. The duration of necrotizing fasciitis is just over three hours, and the progression to this point is impossible for anyone to predict in advance. And more than 50 hours ago, it was indeed Streptococcus pyogenes that caused the soldier to develop a perianal abscess. It can only be said that today is Dr. Wang's a bit of a memorization. Spontaneously rupturing perianal abscess can progress to necrotizing fasciitis rather than a more stable anal fistula within three hours, which in itself is very rare.

"Oh, necrotizing fasciitis. Chen Tianyang nodded after listening to Sun Lien's explanation, "That's really going fast." He glanced at the patients who had been repositioned from their side positions to lithotomy positions by the nurses, as well as the surgical wounds that looked rather hideous, and asked, "Do you want to help?"

Doctor Wang only recognized that the short and fat doctor in front of him was Chen Tianyang, and he couldn't help but be overjoyed, "Professor Chen, it's great that you're here." Dr. Wang pointed to the patient lying on the bed and said seriously, "His necrotizing fasciitis involves a large area, and his condition is relatively complex...... Mainly the perineum and gluteus maximus deep fascia also have signs of infection. I'm really not sure about this, but since you're here, why don't you show us your hand?"

As if to make Chen Tianyang less worried, he also deliberately emphasized, "The operation of peacekeeping hospitals is different from that of domestic hospitals, and we don't have so many rules." As long as the lives of these warriors can be saved. I'm going to report to my superiors right now, and they'll definitely agree to let you take over the surgery. ”

Chen Tianyang blinked his eyes, and he didn't come up with a suitable reason for refusing for a long time. To be honest, Lao Chen is old after all, and the fatigue of having undergone more than a dozen surgeries in the American camp has not yet fully recovered. But...... He glanced at the ...... on the stage again Miserable ass.

The consequences of necrotizing fasciitis can be severe, and even if you are rescued, you may be disabled by muscle adhesions. After early and thorough debridement, followed by aggressive negative pressure sustained sustained suction (VSD), the fascia, which has become fluid from necrosis, can at least partially rise back. At that time, the disability may be slightly milder.

Chen Tianyang sighed, stood in front of the operating table, and said to Dr. Wang on the side, "You give me a help." He tilted his head sideways and looked at Sun Lien on the side, "You kid don't want to run - you're the second assistant, you know?"