After Zhou Can cut the wall of the abscess, he first used a curette to carefully and meticulously scrape off the rotten tissue on the wall of the abscess cavity until fresh tissue was exposed. Earned another 11 debridement experience.

Doing this kind of chest wall tuberculosis resection surgery, the most earned is probably the experience value of debridement.

After scraping the abscess, he replaced it with a scalpel and removed the wall of the abscess cavity and the necrotic musculature.

This process may seem easy, but it is actually very testing of excision and separation techniques.

Because the abscess cavity is irregularly shaped, and the removal of necrotic muscle tissue requires careful search for sinus tracts and possible deep abscesses.

The operation not only tests the skills of the surgeon, but also requires the surgeon to have rich surgical experience.

At the same time, it is necessary to be flexible during surgery.

In addition, extra care is required when removing the lesion tissue so as not to injure the surrounding important blood vessels, nerves, tissues and organs.

At this level of surgery, even if the general deputy chief physician comes to the stage, he will feel soft and weak.

Director Xue Yan, Director Le and others unanimously asked Zhou Can to take charge of the operation, taking into account the complexity of the operation process and the requirements for all aspects of technology.

"Good guy, it turns out that Dou Dao is here!"

Modern high-tech examination equipment can bring a lot of convenience to doctors, but the specific surgical process is not easy for you to complete in front of the film.

When you take the film and watch it, you can clearly know how big the abscess cavity is and where the sinus tract is approximately.

If you do imaging, you can clearly know the direction and meridian of the sinus tract.

But when you really cut open the abscess, you will find that this is not the case.

There are so many variables and so many things to be aware of.

After discovering the sinus tract, Zhou Can cut the sinus tract little by little and cleaned it up.

"This sinus passage is really annoying, why did it go into the back of the ribs?"

He dared to say that it was definitely one of the most complex surgeries ever performed.

"How's that going?"

Director Le must know some ways to deal with it, that is, to respect Zhou Can, so he used an inquiring tone.

"There is no choice but to cut off this rib, expose the bottom of the sinus tract, and completely deal with the lesion. Otherwise, our operation would be in vain. ”

Zhou Can can also be regarded as a daring artist and a veteran on the operating table.

See Moves.

Finding sinus tracts piercing behind his ribs, he was determined to gnaw hard bones.

This is also a major principle that Director Hu, Dr. Xu and others taught him when doing surgery. The heart of the doctor's parents is that when treating a patient, he can't fool around a few times and it's over.

It is necessary to think about the surgical plan from the perspective of the patient's interests.

Some doctors who are not strong in medical ethics usually take the lead in considering their own interests when they encounter such big troubles during surgery.

Cutting off the ribs not only increases the difficulty and time of surgery, but also greatly increases the risk of unknowns.

When the time comes, explain to the family, and there may be a rip-off, or even be complained.

Instead of doing good deeds and getting into trouble.

It is better to sew up the wound with a clear conscience and tell the patient that the operation is ready. As for the recurrence of the patient after surgery, it is because the patient is unlucky and can only enter the uterus for the second time and have another operation.

In the operating rooms of major hospitals, there are not a few patients who enter the uterus for the second time.

Not to mention that every patient who enters the uterus for the second time is because the doctor is immoral and does not do the operation thoroughly, at least more than forty percent of them are such a result.

Sometimes it may not be that doctors are unethical, but that the level of doctors is only that high.

You ask him to do this surgery ten times, and he can guarantee that the patient needs a second operation ten times.

Overall, the current tense doctor-patient relationship is also a major reason that forces doctors to choose defensive medical measures.

He rarely saw bones with his hands, especially the ribs and skull.

This is the opportunity to practice your hands.

If the surgical technique is not used for a long time, it is easy to rust, and even the skills are rusty and regress.

It is also not conducive to the upgrading of medical skills.

After careful sawing of the ribs, the sinus tract was revealed. It is dissected up to the bottom of the sinus tract. Then scrape clean with a curette.

"Sister Yan, can you help see if this rib is broken?"

Patients like this who invade the back of the ribs are prone to necrosis if the ribs are not treated promptly.

"The situation is good, I don't see necrosis."

After reading it, Director Xueyan gave her opinion.

Women are careful, and it is often a good choice to let a female doctor check some detailed lesions.

This patient was fortunate to meet Zhou Can, and in order to cure this person's disease, he almost did whatever it takes, regardless of the cost.

He began to remove the sinus tract.

Dissection and resection are on the rise.

The difficulty of the operation itself is not low, and it is normal to get some experience points rewarded.

"Hey, there seems to be an abscess cavity here! Give me an empty needle with a tube. Zhou Can felt that there might be a lot of pus in the newly discovered deep abscess cavity.

The difficulty of the puncture is almost zero.

When I tried to extract the pus inside, I actually pumped out about seventy or eighty milliliters.

This deep cavity is much larger than expected.

"It's no wonder that when I look at the CT film, I always feel that there is something wrong with this area! It seems that when encountering such patients in the future, you should not be superstitious about the CT results, and you should be careful that the abscess cavities overlap, which will lead to missed diagnosis of the scan results. ”

Director Xue Yan suddenly realized at this moment.

Not to mention her, even Zhou Can has gained a lot.

Studying medicine is like this, accumulating over time, and constantly making progress in practice.

After Zhou Can's efforts, the deep abscess cavity was cleaned again, and then separated and removed little by little.

"It's so dangerous, there's a small sinus passage here. Fortunately, it was discovered, otherwise this patient would have been more than lucky. ”

When removing the deep abscess, Zhou Can found another sinus tract.

It's small, but the depth is already quite deep.

When an abscess is encountered during surgery, the surgeon will generally try to drain the pus as long as there is a condition, and wait until the right opportunity to perform the operation.

This is because the abscess has a strong ability to invade the surgical wound and the tissues in the body.

If the abscess is not removed completely, it is very likely that a second infection will occur and recurrence.

There are even some unexpected postoperative complications.

……

Nearly an hour later, the surgery was completed.

Zhou Can looked at the many medical experience points he had gained and felt very satisfied. What's more meaningful is that the patient's illness has been successfully removed, as long as he is sent back to the ward for good care, if nothing else, the patient can recover quickly.

Many of these patients have a recurrence of tuberculosis and feel that it is caused by the incurable TB.

In fact, it is more likely that the lesion is not completely removed, or the residual cavity is left when the incision is closed, or the preoperative antituberculosis is insufficient, resulting in active tuberculosis lesions in other parts and original drug-resistant Mycobacterium tuberculosis infection, and eventually cause tuberculosis recurrence.

Doctor-patient trust is very important in the treatment of such diseases.

Then we must have confidence, the surgeon must have confidence, and the patients and their families must also have confidence. As long as you believe that the disease can be eliminated, most of them will be cured in the end.

If there is a recurrence of tuberculosis, all kinds of doubts will be formed against the doctor.

In this case, it is recommended to change hospitals and find another doctor for treatment.

Look for the original doctor again, because the trust level is gone, and the doctor will be extremely conservative in the treatment. This is commonly known as a defensive medical strategy.

"Thank you for your hard work, the old rules, I've already set a supper, everyone eats and then leaves. Or take it home and eat it! ”

Director Xue Yan was very happy to see the successful completion of the operation.

The Department of Cardiothoracic Surgery, under her leadership, rose up little by little.

In the eyes of many, this is a miracle.

Director Hu Kan passed away suddenly, and the Department of Cardiothoracic Surgery was in a state of scarcity. In addition, Director Xue Yan lacked the experience of leading a large department, and under the joint encirclement and suppression of multiple external hospitals, she was in chaos and forcibly performed a difficult cardiothoracic surgery, resulting in the patient dying on the operating table.

At that time, everyone in cardiothoracic surgery was willing to collapse.

Including the senior management of Tuya Hospital, they are ready for an emergency change of leadership.

At the critical moment, Zhou Can spared no effort to help Director Xueyan and the Department of Cardiothoracic Surgery, coupled with her regaining confidence and continuous efforts, this is a little bit of today's situation.

Vice President Zhang of the Third Hospital will put down his identity and personally go to the emergency department of Tuya Hospital to interview Zhou Can, trying his best to dig Zhou Can.

It is enough to show that the cardiothoracic surgery department of Tuya Hospital has regained its foothold.

Although it is not as good as the peak period, the Third Hospital, the Provincial People's Hospital, and the Xinxiang Hospital should all feel the huge pressure.

Just like a country, when a neighbor grows stronger, its neighbor will definitely feel a lot of pressure.

If you really have strength, you don't need to do any publicity.

Even if you keep a low profile, your opponents can feel your strength.

There are only so many patients in cardiothoracic surgery in this province, except for some cases that can be digested by small and medium-sized hospitals, what is left is the cake of a few compounds.

When the situation in Tuya Hospital was not good last year, there was a large loss of patients in the Department of Cardiothoracic Surgery, and other hospitals must have tasted the benefits.

Nowadays, the cardiothoracic surgery department of Tuya Hospital is rising again, attracting more and more patients, and those hospitals can naturally detect that the number of outpatient and emergency departments is decreasing little by little.

It is no secret that the cure rate of each hospital and the number of outpatient and emergency departments are not secret.

If you want to check it, you can find it out as soon as you check it.

"Zhou Can, how about going to my office for a few words?"

After Director Xueyan took off her gloves and mask, she sent an invitation to Zhou Can.

She knew that Zhou Can was very busy during the day, and she only had the opportunity to chat with him after the operation.

Instead of talking here, I invited him to the office and explained that I didn't want anyone else to know about what I was going to talk about.

"No problem!"

Zhou Can readily agreed.

The two came to Director Xueyan's department director's office one after another, and she was about to make tea for Zhou Can, but was stopped by Zhou Can.

"It's not an outsider, Sister Yan doesn't have to be polite. Just say something directly. ”

"Then I really didn't treat you as a guest! I think the strength of cardiothoracic surgery is quite good, the number of outpatient and emergency departments is increasing every month, and the cure rate is getting higher and higher. So I want to do a wave of publicity and increase the popularity even more, do you think it's okay? ”

Director Xueyan suffered a big loss last year, and now if there is any major matter, he will discuss it with Zhou Can.

At the beginning, Zhou Can offered her three good strategies, one of which was to develop her head and do practical things, not caring about fame and fame and outpatient volume.

It is precisely this low-key strategy of 'accumulating grain and building high walls' that has helped the Department of Cardiothoracic Surgery of Tuya Hospital get rid of many burdens and have the energy and determination to develop.

"It's been silent for too long, Sister Yan, is this trying to rush to the branches?"

Zhou Can asked with a smile.

"Sort of!"

Director Xueyan nodded slightly.

"Your ambition is really not big! I thought that even if you didn't spread your wings like Kunpeng and soared to 90,000 miles, at least you would go straight to the sky like an eagle. It's just rushing up to the branches, and the pattern is so small! ”

Zhou Can felt that cardiothoracic surgery could fly higher.

At the beginning, he promised Director Hu Kan that he would help the cardiothoracic surgeon and Director Xueyan, and he had this ambition, thinking that at least Tuya's cardiothoracic surgery could be built into one of the top ten cardiothoracic departments in China.

"Oh, you're talking to me! It's so bad! ”

Director Xueyan scolded.

"To be serious, Sister Yan has promoted this time, but there is no big problem. Maybe we can also take the opportunity to snatch back some key patients from other compounds. However, I would recommend that you do your homework. After the publicity, it will definitely attract more patients, and there will definitely be some difficult cases at that time, and whether you can eat it or not must be considered. If you can't eat, then you must think of a way out, and you must not slap your swollen face and become fat, knowing that it can't be cured, and still admit the patient. ”

Zhou Can's later words were not said again.

I believe that Director Xueyan will be able to comprehend.

If a difficult case is admitted to the hospital, knowing that it is not capable of treatment, and it is necessary to perform surgery on others, then another patient dies on the operating table, or a second-class medical accident, the consequences will be extremely serious.

It's basically the same as shooting yourself in the foot.

"I'll be prepared and ready to do it again. Any other suggestions? ”

Xue Yan takes his opinion very seriously.

When it comes to strategy, women are inherently inferior to men.

Because men have stronger logical thinking, coupled with more courage, they should also be broad-minded than women, and they will look at problems more comprehensively.

Since ancient times, those who have achieved great things have basically been men, and it is really not caused by the inferiority of men and women in feudal society.

Women were difficult to get ahead in ancient times, and they were influenced by the feudal system, but not all.

In ancient times, there were not no empresses, but they were very few.

"When I advertise, I want to be targeted, and it is best to be able to build on my strengths and avoid my weaknesses. For example, when I was in Xinxiang Hospital, I treated a child with a dislocated joint. This was the case when I was being promoted. So, during that time, the people who came to see me were basically children with various fractures. It even includes some children with associated skeletal deformities. ”

Zhou Can's meaning is very clear, that is, when she selects publicity cases, she must choose the treatment area that the department is good at.

For example, tricuspid valve surgery is currently done in average and is not particularly good.

It is necessary to reduce the publicity of such cases as much as possible.

This maximizes the attraction of patients who match their ability to treat.

"I've made it all down, do you have any other suggestions?"

Director Xueyan carefully recorded it in the notebook.

"Not for the time being, if I think of it, I'll call or tell you on WeChat."

Zhou Can personally thinks that it is good not to be in a hurry to publicize it for the time being.

However, he can understand that Director Xueyan has been suppressed for too long, and now he finally has a little strength, and he wants to raise his eyebrows and exhale once. And the rest of the department also needs to boost morale through such a publicity campaign.

"Among the publicity cases that I am going to select, the baby with heart failure who was transferred from the Third Hospital is among them, do you think it is feasible? After publicity, it will definitely make the Third Hospital feel that they are stepping on their upper position. ”

She raised a highly sensitive issue.

(End of chapter)