Time was like water, and two days passed in a flash, and it was Friday.

Monday and Friday are the days of Professor Deng Yong's surgery.

Afternoon, 3:42 p.m. Of the seven surgeries in this group, four of them were solved by Professor Deng Yong with superb skills.

The remaining three relatively minor surgeries were divided into separate stages.

There are a large number of people in the group, Associate Professor Xie Jinyuan can take charge of himself, basically all the surgeries can be done, even if it is a difficult operation performed by Professor Deng Yong, he can barely stand up, but the proficiency and technical proficiency are not as good as Deng Yong.

I took the last moderately difficult pelvic fracture incisional reduction and internal fixation surgery in my hand, called a doctor and a master's student, and opened the stage.

Yuan Weihong took a small bone defect, and Qin Geluo's attending physician found a simple fracture open reduction and internal fixation, and also took someone to find the operating room.

Yuan Weihong's master and apprentice are on the same stage!

This is the strength of the surgical team in the top hospital, gathering is a dragon, scattered is full of stars, as long as the operating room is enough, four surgeries can be opened at any time.

At this moment, Fang Ziye stood in the main knife position, Yuan Weihong was temporarily in the assistant position, and Jiehan was in the second assistant position.

After the surgical aseptic film on the foot, Yuan Weihong used toothed forceps to make points one by one, and then drew an arc and threw the curved plate in front of Fang Ziye.

"Follow this line, let's start cutting." From the mouth of his youngest student, Yuan Weihong already knew Fang Ziye's current incision technique, and he had completed the level of plasticine cutting in the practice room.

But he didn't witness it with his own eyes, so he wanted to take a good look at Fang Ziye's current basic skills.

Fang Ziye was not polite, and muttered in his mouth: "On the front side of the thigh, the subcutaneous fascia layer is about 4mm, and the depth of the first incision is about 3mm, which can avoid cutting the blood vessels of the fascia layer and reduce the amount of bleeding." ”

This is the advantage of practicing in strict accordance with the standards in the practice room, and after being flexibly applied in the clinic, you can quickly get started.

Fang Ziye holds the pen knife, vertical inlet, arc pass, vertical outlet.

As soon as the knife comes down, it is crisp and neat, without dragging mud and water at all.

Yuan Weihong wiped the expression of the wound with a dry cotton pad, and the blood stains were only very small, and the wound was quite dry.

Yuan Weihong knew that Fang Ziye's current skills were indeed deeper than before, and when Fang Ziye was incised, either the arc was not positioned accurately, deviating from the preoperative design, or the depth was different, and the blood vessels would be broken locally, and a large amount of blood would seep out.

"Electric knife, electrocoagulation function, cut!" Yuan Weihong motioned for Jiehan to use tweezers to open the external skin incision, and handed the electric knife to Fang Ziye.

The electric knife has two functions: electrocoagulation and electrocautery, electrocautery is used simply to stop bleeding, and electrocoagulation is used for incision.

Fang Ziye was not tricked by Yuan Weihong, and turned his head: "Touring teacher, adjust the electric knife current." 40！ ”

If you really cut it, then it is a layman, Fang Ziye has always been cautious and steady, and it is impossible to cut it at 60mA.

Yuan Weihong sniffed, originally planning to test whether Fang Ziye's temperament was floating after the improvement of his ability, but he didn't test it.

After the skin is incised, what needs to be exposed is the subcutaneous fascia layer and the fat layer, which are incised with an electric knife, which can stop bleeding during the incision, which is a flexible application of electrocoagulation to stop bleeding.

Fang Ziye gave up one by one, and when he reached the deep fascia layer, he stopped, put the electric knife down, and honestly delegated power.

The next step is about the exposure of muscles, Fang Ziye's basic skills have not yet reached such a depth, so he will not touch it for the time being. picked up two S hooks, handed one to his junior brother Jiehan, and held one in his hand, and tacitly took the suction device in Yuan Weihong's hand.

The meaning is self-explanatory.

Teacher, I can't tell you to do it, but I'm ready to be an assistant.

Yuan Weihong didn't say anything, picked up the hemostat and twisted the deep fascia layer, after the sharp knife broke a little hole, it was blunt rupture, and after the muscle layer was squeezed out, it was replaced by a big S bend.

After exposing the femur, a bone defect is seen. After Fang Ziye excised the scar tissue around the bone defect for debridement......

The ipsilateral fibula with blood vessels was cut and transplanted, and shaped with titanium mesh, a series of operations were complex and exquisite, which made Fang Ziye and Jie Han envious......

However, when the high-rise building is flat, Yuan Weihong's operation also starts with incision and suture debridement.

"Fang Ziye, you suture the inner layer, Jiehan, you suture the subcutaneous, I'll see your suturing skills, what level each is." Yuan Weihong is like an old bird, feeding the chicks.

Fang Ziye was instantly overjoyed when he heard this.

Honestly took over the needle holder and the 3-0 micro Qiao line, and began to play steadily.

Suture, in addition to manipulation, a certain basic cognition is required.

The periosteal layer definitely needs to be sutured, and the suture here can be done continuously, with a stitch to the end, after the suture, it is still layered, and the periosteal layer is very well aligned.

Then there is the deep fascia layer, which can be sutured continuously or simply interrupted, and at this time, a certain amount of effort is required.

The stitches are almost close, that is, the deep fascia is closed into a lump. The fit is very good, just like a half-layer stitched orange peel, so that it is just the right fit.

Fang Ziye has reached such a level.

The muscle layer is not cut, and the teacher Yuan Weihong walks between the muscles, so there is no need to deal with it.

Then there is the subcutaneous fat layer, and the suture of the fat layer is more sophisticated full-thickness suture.

It also needs to be tightly closed, and it cannot be too tight to cause local fat compression, so that the fat liquefaction occurs after surgery, which is similar to suturing tofu.

Fang Ziye operated two stitches, the corners of his mouth showed bitterness, and he looked at Yuan Weihong.

Yuan Weihong said: "It's okay, it's okay to make do, continue to sew." ”

Sometimes, the small local operation is not the optimal solution, and it has little impact on the overall operation, Fang Ziye is just not so well sutured, not that it cannot be completed, but the level is high and low, and it is clear at a glance.

Sutures in more critical locations, such as near the joint capsule, require more delicate sutures to avoid functional limitations for the patient.

Fang Ziye honestly completed the fat layer step by step, and the degree of completion was really not high. But when it comes to the subcutaneous fascia layer and the subcutaneous layer, this goes back to the operation of the orange peel suture style.

Fang Ziye once again packed up his confidence and finished stitching the subcutaneous layer, so that the skin fit very well, there is a kind of aunt who used to be a doctor and brother who stitched up, looked at everything, and looked at the results with a smile.

The pressure was put on the junior brother Jiehan here.

Jiehan is trembling at the moment, he has just arrived, but he is just a newcomer in the department, and the only medical skill that he has mastered relatively well is suture.

The depth control is not enough, one needle is deep, and the other needle is shallow.

After only two stitches, Yuan Weihong couldn't stand it anymore, and directly cut the knot: "Forget it, you better go back to the practice room and continue to stay for a while." ”

"It's hard for us to explain to the patients and their families when we go back to the ward."

Jiehan was like being amnestied, and handed the needle to the senior brother again, his eyes were curious and expectant, just like Fang Ziye two years ago.

……

After the operation, the younger brother Jiehan is responsible for escorting the patient to the ward.

Fang Ziye took a huge amount of 4 knowledge points and went down to the locker room with Yuan Weihong.

Yuan Weihong was silent all the way, and Fang Ziye didn't dare to speak, but there was a different color in his eyes, as if he was looking forward to it and scared.

However, after all, Yuan Weihong couldn't hold back first, turned his head and said, "Although you have improved your basic skills a little now, it is still a little too late." ”

"It's mid-August, less than half a year before our hospital's doctoral admissions."

"If you still have a year and a half, you can still fight. But if you want to get out of the first practice room, even if you are only facing the 'castrated version' requirements that you need to face for a master's degree, it is a bit late. ”

"Let's get a job."

Fang Ziye didn't give up and asked, "Master, what are the actual requirements for our master to get out of the first practice room?" ”

Yuan Weihong glanced at Fang Ziye, and he couldn't bear it, so he simply let Fang Ziye die, and explained the harsh requirements one by one: "Stitch the tofu well, and the incision technique must be able to cut the tofu into an octahedral pyramid, and the echelons are clear." ”

"Debridement requires that tofu be carved into three-dimensional simplified characters, while hemostasis requires that blood vessel bleeding points be quickly captured at fixed points, and within 20 seconds, a single point can be repeated 40 times, and the standard completion degree is higher than 36 times."

When Fang Ziye heard this, he instinctively despaired.

But after thinking about it again, he only remained silent, but his eyes were full of unyielding.

Yuan Weihong turned his head, and after seeing Fang Ziye's eyes, he tilted his head and said in Fang Ziye's ear: "Tomorrow, I will go to the financial department to report the page fee, you have a SCI article in the first district, you need to study the content carefully." ”

"It must be ripe within a month, and the data is exactly right, and I remember it all."

"Anyone asks, the writer is you, I'm just the instructor, and then prepare well for the doctoral exam in the outer courtyard. Hear no! ”

Fang Ziye froze first, and his heart warmed.