Doctor's Life Simulator

Chapter 146 The operation was successful, I want to learn "Qin Fa" (for subscription)
After Qin Lang's voice fell, the three of them were all overwhelmed by his aura.

Director Xie and Director Tian Hua were a little unfamiliar with photochemical tissue bonding technology and amniotic membrane wrapping, so Shen Jiachen introduced the whole process to them.

"It was the first time I saw Qin Lang use this improved suture method, and I was also amazed. This is a combination of the latest scientific research results of Professor Shen Xi in the field of cancer prevention and treatment, and Qin Lang's improved suture method. It is a very remarkable results."

This time, Xie Yuhua really had a little admiration for Qin Lang, and was full of admiration for this brand-new systematic treatment plan for hand glove injury:

"Doctor Qin, your "Qin Fa" today really opened my eyes, it's amazing!"

It's really that Qin Lang is too young. At this age, they are still learning from the teacher and practicing basic skills.

Shen Jiachen was also filled with emotion, Qin Lang really brought him surprises and shocks every time they met.

"You are really young and promising. At such a young age, you have already led the team to study such high-level research results. Moreover, once your systematic treatment plan for glove injury is promoted, it will really be able to establish a school. !"

Tian Hua also looked at Qin Lang with admiration, and his heart was full of jealousy. How could Wei Guoqiang accept such a clinical genius as Qin Lang.

Now, relying on the core surgical procedures carried out by Qinlang, a nationwide wound treatment center has been developed. In time, the burn and plastic surgery department in Hecheng City will reach a remarkable position.

Thinking of Wei Guoqiang's Versailles remarks in a group of several people:
My wife ordered me a very expensive British-style suit, but I was clearly on the radio station's "Travel Morning Rush".What a loser.

Tian Hua became more and more depressed and envious.

The three directors and Qin Lang systematically sorted out the plan. After admiring, they decided on the candidate for the operation. After all, it is Hecheng's territory.

Qin Lang was the chief surgeon and presided over the entire operation, Director Tian Hua was personally an assistant, and Director Shen was responsible for the preparation of the amniotic membrane.

Director Xie watched and supervised.

High emotional intelligence: expert style of guidance and check.

Low EQ: Salted fish who only call 666 to Qin Lang.

An hour later, the entire operation began.

After the patient's hand was stripped from the abdominal wall bagged flap, the reconstruction and repair of tendons and nerves began.

Director Tian Hua and Director Xie Yuhua also saw the half-knot locking tendon suture method pioneered by Qin Lang for the first time.

On the operating table, Qin Lang's hands stably controlled the needle and thread, and the needle was inserted vertically from the broken end of the tendon. The strength and angle of the control were as pure as fire, parallel to the tendon fibers, and the side distance was 6/[-] of the diameter of the tendon. At the [-]mm of the broken end, the needle exits from the side.

The whole set of movements was smooth and smooth, and Xie Yuhua finally understood why Tian Hua and Shen Jiachen admired Qin Lang's suture technique so much.

"It is indeed the top level in China!"

Xie Yuhua's qualifications and experience, and the weight of these words, if it gets out, Qin Lang will definitely have a place in the field of tendon suture repair in the whole country.

Although Tian Hua and Shen Jiachen have seen Qin Lang's stitching art before, watching it live again is also a new inspiration and comprehension.

Through Qin Lang's operation, even they can learn some micromanipulation skills.

Soon, Qin Lang started the core technique of this suture method. With the needle exit as the center, the needle enters and exits horizontally in the direction of the equidistant vertical tendon, including tendon fibers, which is about 1/6 of the cross-sectional area of ​​the tendon. A small loop is formed between where the first needle exits and the second needle enters.

"Amazing."

Seeing Qin Lang's quick operation, Xie Yuhua was also amazed in her heart.

Tian Hua at the side also came up with an idea, how about finding more opportunities to watch Qin Lang's operation in the name of inspecting Yang Yi and Yang Yue's study progress, and learn a few tricks secretly.

Soon, under this cycle of steps, Qin Lang completed all the half-knots, and a tendon was completed.

At the same time, Director Shen Jiachen also prepared amniotic membrane slices, after repeated washing with normal saline and PBS liquid, soaked and rinsed them in DPBS solution added with penicillin, streptomycin and amphotericin B, and then On the ultra-clean table, the amniotic membrane was spread flat on the sterile PVDF membrane, cut into 3cmX3cm size, and then delivered to Qin Lang.

Qin Lang nodded, and Xiao Zhizi retreated to the side, and Xie Xianyu stood shoulder to shoulder.

With both hands meticulously wrapped the tendon injury area with amniotic membrane, and then used the American Iridex Ocu Light TX laser machine, Qin Lang gave instructions to the equipment nurse:

"The output wavelength is 532 nm, the irradiance density is 0.5 W cm-2, adjusted to the optimal light parameter 200 J cm-2"

".The photosensitizer is Rose Bengal, Sigma Company, USA, concentration: 1 g L-1 (0.1%)"

Under Qin Lang's command, the amniotic membrane-wrapped area was irradiated for 400 seconds. After completing this step, the most critical skin flap cutting and transplantation suturing began.

After a rubber tourniquet is applied to the patient's ankle, the first flap is taken.

Qin Lang controlled the silver scalpel with one hand, and used his thumb and index finger to tighten and fix the skin on both sides of the incision with the other hand. He controlled the blade to be perpendicular to the skin, and cut down evenly with force.

After the silver light passes, the length and depth required for incision are precisely achieved.

"Beautiful!"

Xie Yuhua was refreshed, and she had to say that Qin Lang's operation gave her a huge surprise. It would be great if her team had such an excellent member.

Soon, Qin Lang accurately cut the second toenail flap, the flank flap of the thumb, the dorsal flap of the foot, and the anterolateral thigh flap.

Then there is a second toe flap combined with the medial dorsum of the foot and the trilobate tissue flap of the lateral leaf, and the nail flap is combined with the medial and lateral leaf of the dorsum of the foot
Seeing Qin Lang's pleasing operation, several directors were also full of admiration.

Twenty minutes later, all the flaps were removed by Qin Lang, and the next step was the more difficult comprehensive suture.

First of all, Qin Lang chose the simplest skin flap of the flank of the thumb, using simple interrupted sutures, which is also easy to operate and the most widely used suture method, which is convenient for timely suture removal and drainage without affecting adjacent sutures.

After completing the first suture, according to the characteristics of the flap, Qin Lang naturally chose a continuous suture as a transition.

After the first stitch is knotted, the entire wound is then sutured with this suture. After the previous stitch is finished, the heavy thread tail is pulled out and left on the opposite side, forming a double thread and heavy thread tail knot, which is more firm.

After completing the flap, Qin Lang sewed together a trimmed nail flap and the inner leaflet of the dorsum of the foot.

In this piece, the continuous overlock stitching method is used again. This operation has a good hemostatic effect, and the threads are staggered each time during the stitching process.

"Doctor Qin's level of suturing is also too powerful. He almost adopts the best method according to the characteristics of each flap and the recovery after healing, and can connect with nature. This calculation ability is too strong."

Xie Yuhua had seen big scenes before, but before Qin Lang's most basic sewing operation, she lost her composure.

And this is only one-third of the completion. In fact, this composite flap, after reorganization, will have various joints.

"It's so spiritual, how did you practice this basic skill?"

On the operating table, facing the suture of the fascia, Qin Lang changed to the best figure-of-eight suture method, which is composed of two interrupted sutures. This method is firm and time-saving.

The next moment, for the suture of the vascular pedicle, Qin Lang adopted the penetrating suture method. Due to the large amount of tissue, it is difficult to simply ligate, and the knot is easy to fall off.

When facing the repair of large blood vessels, Qin Lang used a simple horizontal mattress eversion suture method, which can ensure the smoothness of the inner surface of the blood vessels.

As Qin Lang's stitching progress increased, the three directors also understood why Qin Lang dared to call this systematic treatment method "Qin Fa"!
Just choosing the best suture method according to the situation in this step is enough for ordinary doctors to learn for a year or two.

Half an hour later, Qin Lang completed the suturing of all the flaps, and then, the first auxiliary plan was to use flunarizine to prevent vasospasm.

Flunarizine is a new type of selective calcium ion anticoagulation agent, which can selectively prevent the formation of calcium ion influx and prevent vasospasm.

At the same time, it can also improve the color, elasticity, hardness, and control of scars after flap transplantation. It can be said that the effect is remarkable.

Afterwards, hyperbaric oxygen therapy was performed on the patients, using a domestically produced large air pressurized cabin with 2 cabins and 4 doors.

Qin Lang clearly issued various technical parameter requirements:
".Treatment pressure 2.2 ATA, add and decompress for 25 minutes each, wear a mask and inhale pure oxygen for 60 minutes after the pressure is stabilized, once a day, for three consecutive days."

The basic principles of this scheme are:
First, it can increase the oxygen content of body tissues. Second, the diffusion distance of blood oxygen increases. Third, HBOT has a vasoconstrictive effect, reduces local blood volume, and is beneficial to reduce edema.Fourth, HBOT can significantly increase the partial pressure of oxygen in tissues and inhibit the occurrence of infection. Oxygen has the effect of broad-spectrum antibiotics, can also promote the bactericidal effect of white blood cells, and enhance the ability of phagocytes to phagocytose pathogenic microorganisms and remove necrotic cells.

Therefore, after the two-pronged approach of medicine and surgical techniques, the whole operation was successfully completed.

The three directors also let out a long sigh of relief.

Xie Yuhua was the first to applaud, paying tribute and encouragement to Qin Lang.

Tian Hua and Shen Jiazhen were also happy and admired Qin Lang from the bottom of their hearts.

Xie Yuhua said to Shen Jiachen beside her:

"Director Shen, I don't think there is any need to wait any longer. It is more than enough to recommend Dr. Qin for a standing member of the Burn Professional Committee of the Huaguo Medical Association based on Dr. Qin's pioneering "Qin Fa".

"Dr. Qin's clinical talent and basic surgical skills are the best among the young doctors I have ever seen. Even if he is placed among those top directors, he can still occupy a place."

"Now, I finally understand how you feel. It's really regrettable and remorseful to lose such a student."

Xie Yuhua sympathized with Shen Jiachen, and then, the preparation was to join the Burn Professional Committee of the Huaguo Medical Association for the operation of Qin Lang.

This trip to Hecheng was really rewarding.

Tian Hua on the side was thinking: I won't be as promising as you guys.

I, Lao Tian, ​​are going to the Municipal No. [-] Hospital to learn the "Qin method" from Teacher Qin Lang!
ps: Thank you for the reward of 100 starting point coins on Mingyuetianxingkongye, thank you~
(End of this chapter)