Debridement and suturing can be said to be the simplest surgery.

However, there are difficulties and difficulties, and the most important way to distinguish between the location of the injury and the structure of the injury.

Debridement and suturing without any nerves, blood vessels, tendons, especially without injury to the joint cavity, is naturally the simplest, as the name suggests, that is debridement suture.

If there are other concomitant injuries, then additional surgeries such as nerve and vascular anastomosis and tendon suture will be added to the premise of this minor surgery.

This additional surgery is the most difficult.

Among them, the suture of nerves is more difficult than that of blood vessels and greater than tendons.

Lu Cheng carefully recalled these basic knowledge, sorted it out, and checked the surgical field again, and determined that there was only tendon damage, and there was no damage to blood vessels and nerves.

So, he started his own stitching.

Lin You looked at Lu Cheng from time to time, nodding constantly, and was very relieved.

According to his idea this year, Lu Cheng has only been in the department for half a month, and it is not easy to have such achievements and understanding in joint surgery, and it will inevitably consume a lot of time, but Lu Cheng still surprised him again.

Unexpectedly, Lu Cheng even had a dabbling in trauma surgery.

Lin You has been in orthopedics for so many years, whether in terms of experience or operation, he is naturally much deeper than Lu Cheng's kung fu.

Therefore, he understands better what needs to be paid attention to in the operation of surgery.

Noticing these things, it's not too hard, but it's certainly not too easy either.

Some people pursue speed, some people pursue skill,

But Lin You feels that in the face of real technology, speed and skill are far inferior to concepts.

The technique of surgery is that practice makes perfect, there is no surgical method that you can't understand, and the method is just like that, on the Internet and in the literature, everywhere.

You learn, you do, you always grow.

But these concepts need to be followed up from time to time, and the experience of others is transformed into their own experience, so that they are the home of integration. It's also the right way to learn.

Thinking of this, Lin You took the initiative to ask again: "Xiaocheng, do you have any views on the rehabilitation of tendons after surgery?"

"Most of the surgeries in our orthopedic department account for half, and the surgery on tendons accounts for 60% to 70%. ”

Lin You just asked casually.

Because even he didn't have so much time to understand the relevant knowledge and literature of trauma surgery, focusing on joint surgery, his understanding of tendon injuries lagged behind for at least about two years.

And in the past two years, whether there are new things and experiences, he doesn't know at all.

Lu Cheng glanced up at Lin You at this time.

I secretly said in my heart, Master is really a demon-like character, and he has to take everything to me for study.

After organizing the language a little, Lu Cheng combined the basic knowledge and the newly seen experience, and gave examples one by one: "Master, my understanding of tendon injuries is not very deep, and I may not be able to speak completely. ”

In front of Lin You, Lu Cheng didn't dare to say anything, after all, he really couldn't figure out how thick this master's background was.

"First of all, the most important thing after the tendon closure is rehabilitation. This is general knowledge, but it is certainly very difficult to rely on the patient's own consciousness alone. ”

"According to the complications of tendon injury, tendon reinjury and tendon adhesion are mainly complications, I will talk about it in two aspects. ”

"First of all, because Kessler is currently the most versatile suture method, it is mainly due to its stability and reduction of vascular damage at the broken end of the tendon, which helps the tendon to heal. Muscle tissue necrosis caused by poor blood supply is also a type of tendon re-rupture. ”

"Well, we have to think about tendon rupture and what happens during exercise. Since in order to prevent re-injury, the most common way at present is fixation - a combination of activities, fixed with a finger brace, and then during functional exercises, the tools are disarmed, and the finger abdominal muscles are exercised by skin traction, and overexercise is prevented. ”

"In addition, if the patient does not exercise in time after surgery, it is easy to develop adhesions to joint stiffness. ”

"The best way to prevent this is to do it in a timely manner, but it's a proactive factor. ”

"In the current cutting-edge research, there is also a consensus in many trauma surgeries that if a sodium hyaluronate injection can be given after the tendon suture is completed, it can increase the lubrication between the tendons, which can be conducive to postoperative recovery. ”

"It's a passive factor. ”

Speaking of this, Lu Cheng immediately explained rigorously: "Master, I mean other tendon injuries, not the current case, after all, the intramuscular injection of sodium hyaluronate is currently only used in adults, and in minors, there is no experience in using it, so the side effects are not clear." ”

"My advice is not to use it, just to say that there is such an option. If it's an adult, it's worth it. ”

"And sodium hyaluronate is also a cheaper and more affordable way. ”

When Lin You heard this, he didn't speak, and stretched his waist slightly, exhaled and said: "Master seems to be a little tired today, I sewed half of it, come on to the other half, sew it well, pay attention to the handover of the operating class for the patient who comes to wake up, and explain the matters to be paid attention to." ”

"I'll step down first. ”

Lu Cheng was slightly stunned, and hurriedly asked, "Master, how do you exercise after surgery?"

Lin You smiled and said, "Didn't you just say it? It's just a skin seam, it's very simple, I believe you can get it." ”

After Lin You finished speaking, he was about to walk out of the operating room, but when he arrived at the door, he seemed to remember something, and said to Lu Cheng: "Xiaocheng, if you have time and interest, every Wednesday afternoon, there will be orthopedic outpatient surgery, you can go there to wander around, it's all minor surgery." ”

Lu Cheng was stitching, and when he heard this, he quickly raised his head gratefully, bared his teeth and smiled, "Thank you, Master." ”

I can't see the grinning mouth, but I can see the narrowed eyes, and I must be smiling brightly.

After the automatic door of the operating room was closed, the anesthesiologist quietly came up: "Senior brother, this operation is almost over, right? Who is your master? Why does it seem a little fierce?"

Because Lu Cheng is a doctor and even a doctor in this hospital, Huang Youyou asked two questions in a row.

"No, it seems a bit indescribable. "It's said that Lin is especially fierce, but it hasn't come to this point.

Before Lu Cheng could speak, the itinerant and hand-washing nurse began to speak as if she had finally relieved her breath: "Brother You of the Department of Orthopedics, he also has a name called Teacher You." He also has another name, You's Driving School. ”

"You're okay today, our nurses in the orthopedic department are all immunized by his jokes. ”

"But maybe I don't like to joke that much, but today it looks pretty serious. ”

It wasn't until the surgical nurse finished speaking that he had time to explain to Huang Youyou: "Senior sister, I shouldn't look that old, right? In the future, I will need more advice from my senior sister. ”

"Bang dang!"

As soon as Lu Cheng's words fell, the syringe that Huang Youyou was holding in his hand also fell into the instrument tray.

He turned his head suddenly, his eyes wide.

"You're a graduate student this year?"

Lu Cheng nodded.

Lu Cheng's determination made Huang Youyou's eyes change slightly, and he didn't know whether he was sincere or polite, and squeezed out a few words intermittently: "Then you are really awesome." ”

Perhaps he felt that this was a little unladylike, so he quickly explained, "I mean." Don't you see, in trauma surgery, those doctors are scolded like dogs......"

Then Huang Youyou continued to push the medicine.