No news has been sent back.

Dr. Xu went out for about half an hour and then returned to the operating room and continued the operation. Not a word about the gangrene patient.

The teacher is the teacher, and he is really calm, whether the matter has been negotiated or not, so I should give a letter!

Zhou Can was doing surgery in the middle room, and he didn't go out to ask more.

Seeing that it was almost time to get off work, Ma Xiaolan picked up a patient and came in, it was the man whose leg wound had cracked open and had gangrene.

This person's skin is dark, and marks left by long-term sun exposure can be seen on the forehead, arms and other parts.

It stands to reason that this is a middle-aged male patient with a strong body and strong immunity.

Perhaps it is because the nutrition has not been well replenished after the leg injury, and the body has begun to become significantly thinner after a long illness. This is not a good sign.

Before his body is still in good condition, his wound must be cleaned and the place where the sutures should be sutured is sutured.

It was then supplemented by professional medical recuperation to help him recover quickly.

Any disease is as terrible as a fire.

In the beginning, it may be just a spark, but if you find it in time, it can be easily extinguished.

The longer it drags on, the more disadvantageous it becomes.

If you wait for a fire to ignite, it will be very difficult to extinguish it.

If you wait until the house is about to burn down, then go and put out the fire. Even if the fire had been extinguished, the house would have been almost destroyed.

The same is true for treating patients.

It is necessary to stop the disease from raging before the patient's body is still seriously damaged.

This is also the principle of Chinese medicine to treat the disease of desire.

At present, this patient is actually about to become terminally ill.

"I've already assessed his condition, and I'm just going to have spinal anesthesia. The prognosis may not be ideal, so let's do our part! The family strongly demanded to save the limb, and they were willing to try it no matter how big the price was. The same is true for the patients themselves. ”

Dr. Koh walked in.

The anesthesiologist followed, also carrying her 'treasure chest'.

No wonder it took until now to get the patient into the operating room.

After Dr. Xu negotiated with the family, it is likely that he consulted a department leader like Director Lou or Deputy Director Han. They agreed, and then applied to the anesthesiology department.

Then the anesthesiology department sends an anesthesiologist to come and evaluate, talk to the family and the patient, and sign the anesthesia consent form.

A series of cumbersome procedures can be completed so quickly, which is already good.

Probably because of spinal anesthesia, a female anesthesiologist at the attending level came in.

This level of anesthesia surgery is far from the point of dispatching an anesthesiologist at the deputy director level. There is no need for a senior anesthesiologist.

"Beauty, do you need my help to make a waist wear?"

Zhou Can stepped forward to greet him warmly.

"Okay! Director Xu's senior apprentice can help me, I can't ask for it! ”

The female anesthesiologist squeezed out a smile at Zhou Can.

It's so rare to finally meet a normal anesthesiologist.

In Zhou Can's impression, most of the doctors in the anesthesiology department have a cold face and do not smile. Only the official doctor is a little more normal.

However, since the official doctor almost had a medical accident, it seems that he has gradually become less cheerful and smiling.

There must be a reason why the anesthesiology department has been short of staff.

There are many things, tiring, high risk, high pressure, and the income can only be regarded as acceptable.

Why is the income of anesthesiologists not as high as imagined? Zhou Can heard such a thing, about seven or eight years ago, the salaries and bonuses of medical staff were restructured to a certain extent.

As a result, the bonus received by a nurse in a weighted department was nearly 2,000 yuan per month higher than that of an anesthesiologist.

The anesthesiologists felt psychologically unbalanced and came directly to protest en masse.

Later, the leaders of the hospital had no choice, and after a meeting and discussion, they made a rule that made people laugh and cry. The nurse's bonus can be the same as that of the anesthesiologist, but not more than the anesthesiology department.

The matter was eventually settled.

If this is true, it means that the income of anesthesiologists is not as high as expected. Otherwise, I wouldn't have watched the nurse get an extra 2,000 yuan a month bonus, and make such a big fuss.

The work of a nurse is actually very hard.

Old fritters who don't work are not among them. Some lazy nurses don't bother to reach out even if they connect a bottle of salt water, and they do their best to call the new nurses to work.

Hemibody anesthesia, commonly known as spinal anesthesia.

After local disinfection, puncture from the patient's lumbar region, select a suitable spinous process space in the lumbar spine, and inject local anesthetic into the subarachnoid space to cause the loss of sensation in the lower body.

It's easy to say, but it's actually quite difficult to operate.

The average novice anesthesiologist can easily fail.

Zhou Can's injection is already level five, which is the level of the deputy chief physician. Injections include puncture.

All kinds of chest wear, waist wear, and abdominal wear can be easily operated by Zhou Can.

The most difficult part of this anesthesia operation is the lumbar puncture operation.

As a result, Zhou Can completed the lumbar puncture operation with great ease, and admired the female anesthesiologist for a while.

"Do you feel anything in your lower body?"

After a few moments, the anesthetic was estimated to be working, and the female anesthesiologist tested the patient's response.

"I don't feel it! It's numb! ”

"That's right. It indicates that lumbar anesthesia was successfully implemented. ”

The female anesthesiologist also admired Zhou Can's skills even more. For her, there is a rather difficult puncture operation, and when it comes to Zhou Can's hands, it is like playing, and she really envy his weightlifting.

This is a manifestation that only when the strength is strong to a certain extent.

No wonder Director Yu loves this young doctor so much!

"Hurry up and debride the patient! I don't know what the situation inside is, but look at the depth, I'm afraid it's already up to the bone. ”

Dr. Xu looked serious.

Accepting this patient is mainly for the sake of Zhou Can's face.

Of course, Dr. Koh was also moved by compassion.

As long as the doctor has some medical ethics, he has the same belief.

As my loved ones thought, there are not many doctors who can do this.

Zhou Can currently has a level 5 debridement, which is one of the important reasons why he dared to challenge this gangrene debridement operation.

With diamond diamonds, this is the only way to dare to do porcelain work.

Without that strength, it is far from enough to have a doctor's benevolence.

"Dr. Luo, let's help the patient cut off all the stitches first!"

Zhou Can appropriately gave some exercise opportunities to Luo Shishen.

Surgery on gangrene patients is a great test of the doctor's psychological quality. Some people are even prone to vomiting during the procedure.

Surgical masks couldn't stop the disgusting rancid smell at all.

Coupled with the visual impact, it is easy to cause the stomach to turn over and then vomit.

Some novice doctors, the first time they see a dead person, the first time they see a bloody scene, the first time they see a disgusting scene, they may experience serious psychological discomfort. You may not be able to eat for a day or two.

Zhou Can has followed so many chief physicians to perform surgeries, and he has done a lot of surgeries in general surgery, cardiothoracic surgery, and emergency departments, and his psychological quality has already been trained.

If you want to say that the most psychological quality is tested, it may not be the operating room, but the intensive care unit of the intensive care department.

Some of them, such as burn patients, have no skin.

There may even be scabbing and suppuration on the body surface.

It's a tingling look at it.

As mentioned here, scab melting can not only cause great pain to the patient, but also be very dangerous.

In particular, large-scale scabs must be prevented in time.

"I ......"

Luo Shishen's brows were furrowed tightly, wearing gloves, holding the scissors handed to him by Qiao Yu, as if forcing him to jump into the fire pit.

"Hurry up, don't grind!"

Zhou Can urged impatiently.

Luo Shishen is now his subordinate, and if there is a problem, he must supervise it.

Dr. Koh doesn't care about that at all.

Qiao Yu worked as a nurse in the intensive care unit, and she has a strong psychological quality, and she only needs to pass the equipment, but she is indifferent. Ma Xiaolan also seemed to be a little unable to stand this disgusting scene, she stood in the audience, her eyes did not even dare to look at the patient's wound.

The conditions in the operating room themselves are not good.

If it is a laminar flow operating room, even if it is a 10,000-level laminar flow operating room, it can absorb the odor around the operating table and expel it.

Now, everyone will enjoy the smell of rancidity.

"That's, that's a lot of sutures! Isn't it torture! Luo Shishen's hands were trembling, and if he didn't wear a mask during the operation, he would definitely see his disgusted expression.

"Concentrate on it."

Zhou Can shouted again.

In this case, as a senior doctor, you must be strict.

Under his deterrence, he can help Luo Shishen offset some of the discomfort in his heart.

The removal of sutures is generally a knot and a knife.

If it is a continuous stitching method, it is also possible to remove the stitches with only one knife. However, under normal circumstances, the nurse will cut each suture once when removing the sutures.

This is because it is easier to remove the sutures from the patient's cortex.

Under the pressure of Zhou Can, Luo Shishen cut off the sutures section by section and cleaned them up.

Without sutures, the patient's wound is even more cracked.

Pus mixed with blood and dripped down like saliva.

The rancid smell becomes more pungent and tangy.

"Xiaolan, don't be stunned, catch it with a trash can."

Zhou Can: This is a newcomer who deliberately trains the surgical team.

Under normal circumstances, the itinerant nurse may be older than the chief surgeon and does not need to be greeted at all.

Ma Xiaolan came over with a trash can to catch it, twisted her head, and seemed to hold her breath.

"Look at the dots, don't let it slip through the floor. Otherwise, it will be a hassle to clean up. ”

This pus contains a myriad of bacteria, including viruses.

Cleaning and disinfecting is never an easy task.

"Vomit ......"

Ma Xiaolan began to retch, then covered her mouth and ran to the covered trash can.

Dr. Xu shook his head again and again.

Didn't say anything, though.

After all, they are all newcomers.

Maybe some emotions are really contagious. For example, when we yawn, when we see others yawning, we can't help but have the urge to yawn.

At this moment, Ma Xiaolan's vomiting seemed to be contagious to Luo Shishen.

A big guy even vomited with him.

"With this psychological quality, you have to exercise well."

In order not to delay the operation process, Zhou Can personally removed the stitches. It's just a small job, and as long as you can overcome your inner fears and discomforts, it's not difficult.

All the sutures were removed quickly.

"Give me the suction tip so that I can suck up the blood and pus in it."

Zhou Can said to Qiao Yu.

"Give!"

Qiao Yu had already prepared it and handed it to him immediately.

Originally, the work of sucking blood and pus should be done with medical assistance.

Zhou Can took care of Luo Shishen's discomfort and could only operate it himself.

"I'll do it!"

Dr. Xu, who is a teacher, has seen all kinds of scenes. looked indifferent and acted as an assistant to Zhou Can.

After Luo Shishen and Ma Xiaolan finished vomiting, they looked very embarrassed.

Ma Xiaolan burst into tears.

It's really uncomfortable when I vomit.

"You two are watching from the sidelines! You must learn to adapt and adjust, and in the future, you will definitely see a bigger scene with me for surgery. ”

Zhou Can made demands on the two.

The patient looked embarrassed and simply closed his eyes.

It is better to know that the patient should be given general anesthesia.

After cleaning up the blood and pus accumulated inside, Zhou Can began to prepare for the debridement of the patient. In many places, the meat has completely rotted.

"Xiao Zhou, tell me about your debridement ideas."

What Dr. Xu meant by this was to tell Zhou Can not to rush the knife.

"This patient's gangrene is wet gangrene, and the wound is deep and shallow, and I am going to devour the wound in stages and batches. Today, the tissues that have been clearly necrotic are mainly debrided in a timely manner, and the tissues whose boundaries are unclear and it is difficult to determine whether they are completely necrotic are temporarily retained. ”

Zhou Can gave his own idea of surgery.

There are many surgeons who take it for granted that when debridement a patient with gangrene, he must go through the knife and clean up as much of the junction tissue as possible. Even the normal tissue parts are cleaned a little more.

In fact, this line of thinking is wrong.

If you do this, it is likely to worsen your condition.

When debridement of a patient with wet gangrene, as Zhou Can did, as Zhou can, as much normal tissue should be preserved as much as possible. Don't rush it.

If you can't eat hot tofu in a hurry, it is also suitable for surgery.

Remove all decaying tissue, even some of the normal tissue, at once and keep the wound clean. I thought to myself, this time the wound is cleaned, it will definitely be fine.

That's just wishful thinking on the part of the new cradle doctors.

A surgeon with real experience will definitely follow Zhou Can's ideas.

"You've got a pretty good idea, let's start cleaning up!"

After hearing this, Dr. Xu not only appreciated Zhou Can more, but also let him operate with confidence.

Zhou Can first cleaned up the obviously necrotic tissues.

The wound is then preliminarily cleaned, and careful identification of which areas should be left and which should be removed.

The process is far more difficult than you think.

It is a great test of the patience and carefulness of the doctor concerned, and at the same time, there are certain requirements for the knife technique. Some parts are cut directly with scissors.

……

After more than three hours, Zhou Can looked at the patient's wound with a satisfied expression.

The wound that was full of pus has now changed its appearance and has been renewed.

The place where the bleeding stops is to stop the bleeding.

The obvious pus and carrion are almost not visible.

(End of chapter)