After Xiao Su leaves.

Dean Pan, the Health Bureau, the Township Government, and the Village Chief Fang all came to see Yang Ping to express their gratitude, condolences and apologies.

Tian Yuan reported Yang Ping's injury to Director Han, and Director Han reacted very much after hearing this, and ordered Tian Yuan: shorten the time of supporting the side, collect the troops in advance, and wait for him to notify him of the specific withdrawal time.

Then the phone immediately called Yang Ping, anxiously asked about the injury, and told him to rest well.

Soon Director Tian and Song Zimo both received phone calls, and Director Han told them to take care of Yang Ping and not to be infected.

After about ten minutes, Director Han's phone called Tianyuan's mobile phone again.

After answering the phone, Director Tian said: "I will go back early the day after tomorrow, the hospital will send a car to pick it up, and the car will arrive tomorrow, and we will all go back in advance in the orthopedic department." ”

"I told Director Han, and Xiao Su went back too." Director Tian added.

Tian Yuan was very busy, the mobile phone rang again, Dean Pan, he received a notice from his superiors, because there was an emergency in Sanbo Hospital, and several of the medical team had to go back early. ”

"Want to go back early? Patients with chronic osteomyelitis of the femur, Xiao Xu, have not had surgery yet? Yang Ping has always been thinking about this patient.

A small amount of bacterial culture, the one with exposed bone was cultured with coagulase-negative staphylococcus, and the others did not culture bacteria, which was consistent with the expected judgment and could be discharged.

Director Tian said: "Just leave the operation to Director Zeng, and you can explain the key points of the operation." ”

Yang Ping was not at ease: "That's not good, this operation must be very thorough to remove the infected bone tissue, if there is a little bit of it not cleaned, the operation will fail." ”

"Then let him do it later." Director Tian is also embarrassed, the time for the return trip has been set, and it is difficult to change it according to Director Han's temper.

"His economic conditions are not good, and now he has no money to go to the provincial capital." Yang Ping was very sympathetic to Xiao Xu.

"Let's do it tomorrow, let Song Zimo take the lead." Yang Ping said.

He asked Xiao Wu to call Director Zeng, instructed Director Zeng to sterilize the external fixator and supporting instruments in advance, and told the patient to start fasting and fasting now, and to go for a thin-slice CT scan of the full length of the femur tomorrow morning; Do a bedside vascular color ultrasound to find the recipient artery at the skin defect site and the donor artery at the latissimus dorsi muscle; Then consult with an internal medicine department for perioperative thyroid function management.

"In this patient, every time I have an imaging examination, the scope of infected bone tissue has increased, and I am afraid that if I don't do it now, when the time comes, all the femurs will be infected, and there will be no chance." Yang Ping explained.

"I've seen this patient's film, and I heard that you are thinking about local bone tissue infection in the femur, and other imaging abnormalities are caused by hyperthyroidism bone mineral disease?" Director Tian asked.

"yes, so get rid of the infected bone tissue as soon as possible." Yang Ping said.

"I'll also come to the stage tomorrow to help Song Zimo." Director Tian was very interested. After arranging the operation, Yang Ping was relieved.

In the evening, Yang Ping rested early.

Entering the system, several more experimental subjects were dissected, and the anatomical image of the human body was initially established in the mind.

Doctors, especially surgeons, are very important in their ability to compose.

Yang Ping already has a strong ability to compose, and through the powerful training of the system, the human anatomy diagram in the brain gradually becomes clear. With the eyes closed, the main viscera, nerves, and blood vessels are clear, but some details need to be further strengthened.

In the system, although it does not consume physical energy, psychological fatigue still exists, so I didn't stay long, I came out of the space and slept.

Early the next morning, Xiao Su came to WeChat, waited outside the dormitory, and accompanied her to breakfast.

Looking at the corner, Xiao Su fed Yang Ping breakfast one bite at a time.

Liang Fatzi said: "The first time I watched them, I felt that there was a story. ”

"What's the story?" Zhang Lin is curious, and there are stories he doesn't know?

The fat man said with confidence: "That night, the emergency diagnosis refers to Brother Yang's first operation, and Xiao Su is the instrument nurse, and the two of them have the wrong eyes." ”

"Wouldn't it? No wonder, I knew each other before, you said that the senior brother came to Sanbo from the People's Hospital, wouldn't it be for Xiao Su. Zhang Lin touched his chin, boldly guessed, and dug up the story, he has talent.

The fat man nodded affirmatively: "Eighty percent is, the two of them were secretive before, if it weren't for Brother Yang's hand injury this time, he would have to hide it, how deep is this hidden." ”

Zhang Lin said: "Yes, this guy, some time ago, a few of us suspected that they were going to get married, but the senior brother was still stubborn and didn't admit it, now it seems that our guess is right." ”

Xiao Wu was silent on the side.

"Why are you dumb today?" Zhang Lin asked him.

Xiao Wu is also blindsided now, and he can't figure it out.

After handing over the shift, Yang Ping was inconvenient to make rounds, so Song Zimo took everyone to check the room.

After checking the room, in the doctor's office, everyone was about to discuss Xiao Xu's condition, and there was a lot of noise outside, afraid that it was not the patient who was making trouble, Director Zeng got up: "I'll go out and have a look." ”

"Here, here!" Teacher Yan came in on crutches.

His son and daughter-in-law carried a large pennant with a few golden words on it: Hand to the disease!

"Director Yang, what's wrong with you?" Teacher Yan saw Yang Ping's hand and exclaimed.

Yang Ping smiled: "If you accidentally scratch it, it won't get in the way." ”

Teacher Yan nodded: "That's good, you can't have a problem with your hands." ”

The old man instructed his son and daughter-in-law to bring in the pennant, which was big enough, at least three times as big as usual.

"Director Yang, there is nothing to thank you, send a pennant over to express my heart, I originally wanted to write a poem, but I held it for two days, but I didn't hold it back, so it's appropriate to send these words."

After a lively while, everyone continued to discuss Xiao Xu's condition, and Director Tian also came to the orthopedic department.

Xiao Xu returned to the ward after the CT scan, and the doctor in charge of the bed carried his CT film up, and Director Zeng hung the film on the reading lamp.

"In this patient, there are three main surgical steps: first, remove the intramedullary nail and replace it with an external fixator; 2. Remove all the diseased bone tissue, and fill the bone defect with calcium sulfate containing vancomycin; 3. Use the free latissimus dorsi flap to repair the defective part, the most difficult of which is to remove the infected bone tissue, to be accurate and thorough, every time he performs an imaging examination, the scope of the infected bone tissue is expanding, so we should re-do a thin-slice CT scan before surgery to determine the scope of infection. ”

Yang Ping briefly explained the steps of the operation, and then read the film carefully at the reading lamp, and said: "Straighten the position, the upper edge of the patella is ten centimeters, make a rectangular bone flap, eight centimeters long, three centimeters wide, and the rectangular midline is the midline of this femur." In this way, the infected bone tissue can be completely removed, bring me a piece of paper. ”

Someone pulled a piece of A4 paper from the printer, Yang Ping barely held the pen with a tiger's mouth through the gauze bandage, and began to draw on the paper: "This is the shape of infected bone tissue, this is the shape of a cuboid." ”

An irregular three-dimensional figure is drawn on the paper, surrounded by a regular cuboid.

"How did you figure it out?" Song Zimo looked at the drawings.

Yang Ping said: "Based on the CT scan graphics, 20 percent of the normal bone tissue is added around as a safe area. ”

Song Zimo thought, this requires a strong composition ability, to paint it yourself, it is estimated that it will take measurements, repeated trial paintings, before it can be drawn, he looks at the film like this, and draws it by visual inspection, this is how strong the brain composition imaging ability is.

Director Tian lifted his glasses: "How sure are you of success?"

"In theory, it shouldn't fail." Yang Ping is sure, after all, this range is calculated from the CT scan.

"The skin muscle defect is trimmed into an oval shape, 12 centimeters long and 5 centimeters wide, and the latissimus dorsi muscle flap is routinely increased by 20 percent on this basis, and the latissimus dorsi muscle can repair the defect of the vastus lateralis muscle."

The color ultrasound room came up, and the doctor in charge of the bed notified.

Yang Ping and the doctors in the ultrasound room worked together to find the defect area and the arteries in the latissimus dorsi muscle, and marked all the available arteries one by one.

The flap is to take a piece of skin from one place to make up for the missing skin in another part, and the distance can be made up with the blood vessel transfer position, and the blood vessel will be cut off at a long distance, and then connected with the blood vessel of the defect site.

The musculocutaneous flap is taken together with the muscle skin, which can not only replenish the skin, but also replenish the muscle.

It is all a kind of work of tearing down the east wall and making up the west wall.

Yang Ping asked Song Zimo to draw the shape of the defect and the shape of the flap at the latissimus dorsi muscle with a surgical marker.

"Doctor, when it's done, I'll go to the army."

Xiao Xu still remembers being a soldier.

Yang Ping looked at him wearing glasses: "You are all short-sighted, and you are still a soldier?" ”

Xiao Xu took it off: "Flat mirror, wear it to play." ”

If you can't be a soldier, the young man will know in the future that sometimes there will be contradictions between dreams and reality, and some are irreconcilable contradictions.

The internist looked at the data of thyroid function, which did not affect the operation for the time being, and then rechecked the thyroid function and drug control after the operation, and he went to the operating room to follow the table during the operation to be vigilant for thyroid storm.

Song Zimo is the chief surgeon, Director Tian is the first assistant, and Director Zeng is the second assistant, this operation is not difficult for Song Zimo.

Halfway, for the precise positioning of the infected bone tissue, Yang Ping patiently guided Song Zimo, who also has a certain composition ability, which is easy to understand.

Yang Ping repeatedly confirmed that the infected bone tissue had been completely removed, and there was still a circle of normal bone tissue around it, which was the most ideal condition.

Chronic osteomyelitis is the most troublesome in orthopedics, and orthopedic surgeons are most afraid. Because bacteria are hidden in bone tissue, antibiotics can't reach them, and they can't help bacteria, so once you get chronic osteomyelitis, it can't be cured for many years.

If there is no accident, Xiao Xu should be able to recover this time.