The mutilated right thumb is accompanied by an intact X-ray of the bone of the right foot.

He couldn't help but be horrified.

Don't...... When Director Shen said that he wanted to recreate a thumb for the patient, he wanted to amputate the thumb of the right foot and transplant it to the position of the thumb of the patient's right hand?

The wonderful idea of this trick is really brain-opening.

Extraordinary people would never think of such a trick.

In ancient times, those who built palaces for the emperor were called skilled craftsmen, and modern doctors actually deserve this title.

Although this idea is very bold and ingenious, it is very difficult to transplant.

At least according to Zhou Can's understanding.

The difficulty of replantation is low because the severed finger is the same size, tissue location, and division as the severed finger.

Blood vessels, tendons, nerves, phalanges, and even the skin can all be perfectly connected.

However, the big toe of the right foot is quite different from the thumb of the hand.

How do you pick it up?

If the operation fails, the loss of the patient is too great.

Not only did he lose his right thumb, but he also had to cripple his right foot. In addition, you have to bear the high medical bills and the pain caused by the surgery.

That's really spending money to buy sin.

"It is extremely difficult and risky to transplant the toe to the toe, and it is the first time I have seen this kind of surgery when I have grown so big!"

Dr. He rubbed his hands together with some excitement and said.

"Toe for thumb surgery is a real fourth-level surgery, do you think it is not too difficult?"

Dr. Shan is not much older than him.

The main rule is the main rule, and he has more knowledge than him.

"We doctors need to have the courage to challenge and innovate. There have been two successful cases of toe substitution for thumb surgery in Modu Hospital. As long as the surgery is careful, meticulous and rigorous, the success rate of the operation should not be too low. I have talked to the patient about the risks in case the surgery fails, and he said he is willing to give it a try. ”

Director Shen subtly guided the thinking of the doctors under him.

Establish a good medical style and ethics for them, as well as the concept of practicing medicine.

An excellent chief physician can bring out an excellent team, in addition to excellent skills, their noble medical spirit can also influence generations of people.

"There were many difficulties to overcome in this operation, and it was difficult for me to complete it alone. Dr. Shan is good at microscopic and delicate surgery such as vascular anastomosis and nerve anastomosis. When the time comes, the anastomosis of blood vessels and nerves will be handed over to you. Dr. Chi is a master at tendon reconstruction and repair, and this is up to you. I was responsible for amputating the patient's toe, then making a wound in the missing part of the patient's right thumb, performing the docking of the phalanges with the thumb bones of the hand, and the subsequent flap repair. ”

Director Shen made a division of labor.

"During the toe amputation, the patient's hemostasis, foot wound repair, and suturing work need to be undertaken by a resident doctor. Who is the resident doctor under the two of you who is up to the job? ”

Even if it is the same group of doctors, there is competition.

Doctor Shan and Dr. Chi are both excellent, but it's not enough to be good yourself.

If the resident doctor under his command is also excellent, he can get a lot of points.

"My subordinate Yang Fuhai has done a good job of stopping the bleeding, and Dr. Gandhi has done a great job of wound repair, so it should be very safe for the two of them to undertake this task together."

Dr. Chi was quick to start.

directly helped his two residents to snatch the opportunity to exercise.

"Dr. Tang and Dr. He below me are actually quite good. Dr. Gui Peisheng Zhou's strength is also not weak. "Doctor Shan has a gap with Dr. Chi in terms of qualifications and strength.

grabbed the opportunity to operate and exercise, she couldn't rob the other party at all.

can only weakly help the doctor to snort twice.

"The management of the wound after the amputation of the toe is more complicated, and Dr. Chi has two residents under him, and he has more experience in surgery. This time, the two of them will take care of it. Doctors under Doctor Shan will give other opportunities to exercise when the time comes. ”

In the end, Director Shen chose two residents with more surgical experience.

The two doctors, Yang and Gan, glanced at each other and smiled.

Dr. Tang and Dr. Ho looked gloomy.

The patient was quickly brought into the operating room and given an inhaled general anesthetic for safety.

The anesthesiologist monitors the patient's vital signs throughout the process.

The operation soon began.

Go as planned.

After Director Shen amputated the patient's toe, he treated it first and then refrigerated it.

This is followed by the procedure at the patient's right thumb for the next transplant.

The two doctors, Yang and Gan, have been busy for a long time.

The patient's foot wound was treated with hemostasis, bone grinding, nerve closure and other treatments.

Both of them belong to senior residents, and they have received a lot of exercise in the operating room, and their surgical ability is really not weak.

Dr. Yang's ability to stop bleeding should have reached the intermediate level of a resident doctor.

Infinitely close to the excellent level of residency medicine.

It's not a bit close, though.

Dr. Kim's level of debridement is also excellent, barely close to the excellent level of a resident.

No wonder Dr. Chi is full of confidence in these two under him.

Compared with these two people, Dr. Tang, who is under Dr. Shan, has a big gap. As for Dr. He, he is far worse than others.

In the beginning, Dr. Yang did a pretty good job of hemostasis, and Dr. Gan's debridement was also good.

It's just that problems soon arise.

During the debridement, Dr. Kam opened the ligated blood vessels again.

Then I found that nerve closure was not very easy to do.

What's worse is the stitching.

The depth of the wound treatment is not enough, the wound is too wide, and the skin on both sides cannot be pulled together at all.

One wrong step, one wrong step.

I saw that the two doctors were in a hurry, and they almost didn't fight.

The patient's thumb is amputated and there are arteries. Blood splattered all over the place.

Dr. Yang and Dr. Gan both had a lot of spray on their clothes.

Dr. Kam even had a little blood on his face.

Director Shen frowned at this kind of scene.

Dr. Chi is helping his doctors to play a round.

"It's probably the first time they've dealt with this kind of limb wound on their own, so they're a little inexperienced."

"Teacher, can I let my two men, Dr. Tang and Zhou Can, take over? I see that the two doctors Yang and Gan are indeed inexperienced, and the surgical protective clothing on their bodies is about to be dyed with new tricks! ”

Dr. Shan took the opportunity to strike again.

A humorous metaphor that vividly points out the embarrassment of the two.

Dr. Yang and Dr. Gan couldn't help but blush.

They are all experienced senior residents, because the cooperation is not good enough, coupled with the lack of prediction, it makes a mess.

"The opportunity should be equal for everyone, let the two doctors Tang and Zhou try it! Otherwise, Doctor Shan should say that I am biased! ”

Director Shen couldn't stand it, so he agreed to Dr. Shan's request.

He also wanted to take this opportunity to see Zhou Can's surgical ability.

Rumors are rumors after all, and only by seeing them with his own eyes can he know the bottom of his heart.

Yesterday, I saw Zhou Can's level of separation with my own eyes, and it was really amazing.

"Doctor Shan asked a resident doctor and a trainee to take over, this arrangement is quite interesting!"

Doctor Chi's gaze looked at Zhou Can who walked out.

He still understands Dr. Tang's skills.

What made him curious was that Dr. Shan did not let Dr. He, who had poor surgical ability, fight, but let a regular trainee take action. There is certainly something to this arrangement.

It shows that she has a lot of confidence in this Gui Peisheng surnamed Zhou.

Dr. Chi has also heard someone say in the past two days that the Department of Orthopedic Surgery has a strong trainee.

It's just that according to his thoughts, how strong can Ji Peisheng be?

Soon, Zhou Can let him see how strong Gui Peisheng's surgical level could be.

I saw that after Zhou Can took over, he immediately tied up the patient's foot roots.

Bleeding stops immediately.

Then, unhurriedly use forceps to clamp a blood vessel with severe contracture, stretch it, and ligate it with one hand at the root of the deeper part of the blood vessel. The whole process is skilful and confident.

After this vessel is treated, the second one is treated.

"Dr. Zhou, why did Dr. Yang ligate these blood vessels smoothly at the beginning, but later the debridement caused the ligation of the blood vessels to loosen, and it became very difficult to ligate them?"

Dr. Tang is really ashamed to ask.

Zhou Can's operation stunned him.

Everyone worked under Doctor Shan, and Zhou Can performed well, and he also followed his face.

Dr. Sheep blushed, and he was very curious about the answer to this question.

"The human blood system has a set of self-protection mechanisms. For example, if this blood vessel is broken or broken, it will start to bleed. At this time, in order to stop the bleeding, the body will control the contracture of this blood vessel to shrink and shrink. Not to mention this kind of small blood vessels, even if some large arteries and blood vessels, the time is too long, it is extremely unfavorable for treatment. ”

Zhou Can explained the reasons in detail.

Dr. Yang's ability to stop bleeding and ligation can only be regarded as relatively strong.

Dealing with the blood vessels of fresh wounds may not be a problem.

However, when Dr. Kam later debrided, the ligation of the blood vessel was loosened, or the blood vessel was broken again.

It is much more difficult to get a ligation.

Because by this time, the blood vessels have been retracted and have become smaller.

After hearing this, Dr. Yang was greatly instructed.

At the same time, seeing that the blood vessels that were very difficult to deal with were in Zhou Can's hands, it was like playing.

The level of hemostasis and ligation is obviously much higher than his.

This level is not even weaker than that of Dr. Chi.

Is a regular trainee stronger than the main officer?

He subconsciously turned his head to look at Doctor Chi next to him.

Then I saw Dr. Chi's eyes widen, if it wasn't for the mask. The mouth is likely to be wide open.

Dr. Chi was probably also frightened by Zhou Can's surgical strength.

Mumble!

He swallowed hard.

"Doctor Shan, where did you find such a powerful trainee? No wonder you asked him to work with Dr. Tang to treat the patient's wounds. ”

"Hehe, now I know how good he is! Who told you to bring no rules to the pearson, this time let me pick up a big bargain. ”

The two resident doctors under Doctor Shan can't compare with Dr. Chi's doctors at all.

Now with Zhou Can, it's different.

A regular trainee can fight two.

Zhou Can quickly finished dealing with blood vessels and nerves and looked at Dr. Tang.

"Leave the debridement to me, you can grind the bones, okay?"

"No problem."

Dr. Tang has one of the greatest advantages, that is, he does not fight for merit. Happy to let newcomers perform.

Zhou Can debrided the patient's foot wound.

That's really merciless, some excess meat, tendons and other tissues should be cut off and never kept.

The result is an invaginated wound shape with a concave center and a retained epidermis around it.

[Debridement XP +1.] 】

It's not easy to earn experience points.

[Congratulations on your debridement upgrade to level 4, your current experience value is 1/10000, and the attending doctor is at an inferior level.] 】

This medical skill has finally been elevated to the level of a cure.

It's not easy.

Comparatively speaking, the use of debridement is quite acceptable. For 1,000 first-level surgeries, there are about 350 debridement opportunities.

It's a pity that each time you debride, you can only get 1 experience point.

Unlike injections, hemostasis, sutures, and ligations, one operation can earn more experience points.

After this medical skill was upgraded, he was pleasantly surprised to find that his debridement skills had also been greatly improved.

For example, for the treatment of the same wound, he can now predict how to clean the wound, which is more conducive to suturing and wound healing. It even has a serious impact on whether the wound is susceptible to infection and whether it will have a serious impact on the patient's life after healing.

can have a clear prediction.

In addition, during debridement, we have a more comprehensive understanding of nerves, blood vessels, vital organs and tissues, and masses.

The handling will also be more perfect.

For example, the wound that had already been dealt with was now improved, and after his debridement technique was upgraded to level 4, his cognition improved.

It was easy to find some of the things that were lacking.

Some repairs were made to the wound again.

In the case of that nerve, I only thought about how to close it. Little is known about the effect on this nerve when the wound heals.

Looking at it now, he can clearly see that after the wound heals, as long as he walks in shoes, the phalanges will continue to compress and stimulate this nerve.

It will definitely take a toll on the patient.

So, he improved it, moved it to its proper position, added the protection of the fat layer, and with the cushioning, it would be fine.

It's just a processing detail.

But it fully shows that his debridement level has been greatly improved.

Sometimes, the difference between the level of the director and the attending officer can be just a fraction of a second.

But in surgery, this difference can be a thousand miles away.

For example, in tumor removal, after the tumor is swept away, the location close to the nerve is left with a small hidden danger. His abilities were limited and he did not dare to cut it.

The director completely eliminated the hidden danger.

The difference between the two seems to be a little bit, but the prognosis is worlds apart.

If the main treatment is not cleaned, the tumor cells will metastasize, which may lead to the patient's rapid recurrence.

The operation performed by the owner has been thoroughly cleaned up, and the patient will not recur again, and he can always live a healthy life.

The higher the level of medical skills, the smaller the gap.

It's often reflected in the subtleties, just a fraction of a second.

After Zhou Can's debridement technique was promoted to the fourth level, he was really happy in his heart.

"Doctor Tang, I'll leave the bone grinding to you! Approximately smoothed to this position, it is best to round the tip of the phalanges a little. ”

This is done so that after the patient's wound is healed, the flesh will not be pierced because the bone is too angular.

"Okay!"

Dr. Tang is a senior resident doctor in the Department of Orthopedic Surgery, and he still has no problem grinding his bones.

It was milled in no time.

"Dr. Zhou, what's the matter? Where else do you need to fix it? ”

"The grinding is amazing!"

Zhou Can gave a thumbs up, and there was no problem after checking the wound. Start stitching for the patient.

The patient's wound was sewn into the shape of a duck's beak.

This is also a common suture treatment for amputation wounds.

The main treatment is a medium level of suture, the main treatment is a medium level of ligation, plus the main treatment of the next level of debridement, and the treated wound is enough to score a high score.

After the stitches were completed, he did not skip the level to report to Dr. Shan or Director Shen.

Instead, he gave Dr. Zutang respect without any effort.

"Dr. Tang, are you okay?"

He did most of the work of the operation, but in the end, he asked Dr. Tang, who was not as strong as him, for instructions.

This also won the favor of Dr. Tang.

No one would refuse to deal with someone who is like a spring breeze.

"I think the stitching is very good."

Dr. Tang had a smile on his face.

"Doctor Shan, please help us check if there is still room for improvement in the suturing of the patient's foot wound."

Dr. Shan is watching Director Shen build the transplant interface at the moment.

Wen Yan walked over and examined it carefully.

"You two sew pretty well! When the operation is completed, I will ask Director Shen to take a look. She was extremely satisfied with the performance of Zhou Can and Dr. Tang.

Earned enough face for her.

Usually, when did his doctors win over Dr. Chi's doctors?

Today is the only one.

It was also the first time.

"Damn, the sewing is so perfect, I don't believe he's just a regular trainee."

After seeing it, Dr. Yang and Dr. Gan were deeply shocked.

It's an eye-opener.

There is really a sky outside the sky, and there are people outside the world.

Zhou Can crossed them more than in one medical field. Rather, it is in a number of areas, almost comprehensively surpassed.

This made the two of them feel quite frustrated.

"Doctor Shan, let's discuss! I usually have a lot of surgeries, why don't you let Dr. Zhou follow me to exercise? Seeing that Zhou Can was so good, Doctor Chi directly started his idea.

At the attending level, many times the surgery is performed alone with an assistant.

Their income is also linked to the commission of the operation.

In addition, when evaluating the deputy director, academics are a very important part, and the cumulative number of surgeries, as well as the quality of surgeries, and the difficult surgeries completed, are all very important evaluation criteria.

Dr. Chi should be a senior attending doctor, and he has begun to work hard to challenge the deputy senior title.

Being able to get a strong assistant will be of great help to him in judging the deputy high.

(End of chapter)