Chapter 23 is all about the basic skills of soundness
This surgery is an emergency operation, so the nurse is not a professional orthopedic nurse, but a nurse on duty.
The operation had just begun, and they couldn't go home with or without surgery, washing their hands and making rounds, so they didn't have any anxiety at all. Anyway, in general surgery, even the simplest emergency surgery will not consume much less time.
The operating room is generally equipped with anesthesiologists, itinerant nurses and handwashing nurses.
The anesthesiologist is responsible for anesthesia, the itinerant nurse is responsible for opening the instruments off-stage, and the handwashing nurse is responsible for passing and arranging the instruments on the table.
When the tour heard Lin You say that he was going to get stitches, he was slightly stunned.
Looking at the timing of the operating table, the time was less than 8 minutes.
The exact time is 7 minutes and 36 seconds.
No matter how fast the orthopedic debridement suture is, it won't be sewn now, right?
To be on the safe side, the itinerant nurse asked again: "Teacher, don't you want to take a good look at it again?"
Of course, she didn't question Lu Cheng's meaning when she spoke.
Through the mask, he couldn't tell Lu Cheng's age, but he was definitely younger than Lin You.
"5-0 tendon stitches. ”
"Let's take two first, we'll sew it first, and then take a 4-0 antibacterial Vicryl suture to suture the skin. Lin You said skillfully.
"Okay!" The tour immediately responded, since Lin You had already confirmed, it meant that the operation was really almost over.
It's a bit too fast, and that's a good thing.
But the anesthesiologist on duty today is a regular training girl who is usually on duty with the orthopedic department, and after hearing Lin You's shouting for stitches, her eyes immediately stood up, and Rao glanced at the stage in disbelief.
It was found that Lu Cheng and Lin You had already begun to try to pull the tendons outside.
Only then did I finally make sure that the operation had just begun and was nearing the end, and he sighed slightly and said: "Teacher, you are a teacher of trauma surgery, last time I followed a boss, and I did it for more than six hours, and I saw that the wound was about the same size." ”
"Still without the machine. It's still with you, I feel comfortable. ”
The machine that Huang Youyou is talking about is the mirror and small tweezers sutures of microsurgery. Generally, in the case of nerve damage, the assistance of a microscope is required to perform suturing.
In general, tendon injuries in trauma surgery, if there is no nerve damage, will not take too long.
But the total experience of hospitalization is limited after all.
Of the four CEOs, only one is a professional trauma surgeon, and it is also my good fortune to be able to follow the professional hospitalization manager during the emergency surgery.
After all, as long as there is no emergency surgery in her class, she does not need to stay in the department, and if there is an emergency operation, someone will call her.
Lin You glanced at this girl, and said with a lot of relief: "You girl looks very strange, is it a graduate student or a regular training?"
"I'm in my second year of graduate school this year, and I'm in the same class with Mr. Du today, teacher, how long will it take for you to stitch up, so I'd stop taking the medicine early." "Huang Youyou's eyes narrowed slightly, and he missed the bed a little, so he should stop the medicine early, wake up the patient early, and go back to sleep early.
"Oh, Mr. Du's student. ”
"No wonder you have an opinion about me. "Maybe the operation process was very smooth today, so Lin You naturally felt a little relaxed and began to gossip more.
Surgeons generally do only three things in the operating room.
One, surgery.
Second, flirting with girls.
Three, being molested by a girl.
Huang Youyou was directly blinded by Lin You's words, why did Teacher Du's students have opinions about him?
I haven't heard the teacher say that I had a holiday with the surgeon, right?
What does this Lin You mean?
But he hurriedly said, "Teacher, where is it?"
The anesthesia supervisor and surgeon in the operating room were very familiar, and she didn't want to hear her gossip when her teacher was chatting and drinking tea with this person who didn't know where he came from.
The question is, is she really not?
Lin You looked at Huang Youyou's somewhat cramped appearance, and smiled: "Then you always go to the trauma operating room with Teacher Du, and don't come to our joint surgery." ”
"Isn't the doctor in the trauma surgery department more handsome?"
"I still think that our joint surgeons are faster, so I don't like it. ”
Lu Cheng's eyes immediately blinked, today's Lin You, it seems that his state is a little wrong?
Huang Youyou hurriedly shook his head.
"No, no." ”
"Oh, then I'm going to tell Mr. Li that you said that the people in their trauma surgery are not handsome. And fast. Lin You said.
The car drove so that Huang Youyou was caught off guard, and Huang Youyou was taken aback.
Teacher Li in Lin You's mouth, that is the boss of trauma surgery, the director of the department.
If she really listens to this, then it is estimated that she will not be able to stay in the operating room in the future, and there will be people staring at her in absolutely every operation. I can't escape the fate of being the center of the conversation.
"Teacher, you, can't you do this?" Huang Youyou said anxiously.
"Then why don't you stop the medicine quickly? Don't you want the patient to wake up a little longer and see us a little longer?"
After the operation, the surgeon and anesthesiologist need to wait for the patient to wake up and return to the ward.
Huang Youyou didn't dare to answer anymore, so he quickly stopped taking the medicine......
Lin You found that Lu Cheng was looking at him, and the movements of his hands stopped.
His old face was red, but there was still a mask to block it, and he said, "Hurry up and sew, see what I'm doing?" ”
"Oh!"
Lu Cheng hurriedly began to deal with the tendon of the ring finger, while Lin You was not in a hurry to deal with the tendon of the index finger, because he wanted to see how deep Lu Cheng's professional foundation was.
Are you prepared?
There are many ways to suture tendons, but the newest, best way to suture them is certainly not written in textbooks.
Even if Lu Cheng chooses to stitch with a figure of 8, he won't say anything.
However, when Lin You saw Lu Cheng insert the needle 5mm away from the broken end of the tendon, cross the tendon horizontally, and penetrate it longitudinally from the broken end of the tendon, and use the same method to deal with the broken end of the tendon on the other side, and then tie the thread knot in the broken end of the tendon.
Lin You began to sew.
Kessler is sewn legally, and it's an improved version. It is currently the most commonly used suture method for suturing various flexor and extensor tendons, and it is also the most stable suture.
Of course, in the history of tendon suturing, there have also been Tang sutures. However, in fact, the M-Tang sewing method is not commonly used when it is actually used.
Naturally, not commonly used does not mean that it is useless.
It offers a new concept of tendon suture.
Multi-strand suture.
More studies have proven that the multi-strand Kessler suture method is more effective in the use of tendon sutures.
Lu Cheng was able to understand this, which undoubtedly proved that he had really worked hard, and he had worked hard before choosing to come to orthopedics, not just reading books, nor reading one or two articles.
With such a solid foundation, it is naturally a pleasure to be a teacher.
It's also very reassuring.
Suturing does not pay attention to speed, but the most important thing is the concept, the concept is right, the rehabilitation can keep up, and the postoperative effect will not be bad.