Auto chess in the operating room

Chapter 18 Two Cases of Critical Debridement
Tang Lou looked at his fingers with a solemn expression, he did not expect that the first time he entered the operating room was such an extreme event.

I felt a little nervous and a little hopeful.

The first step before the operation is to wash hands and disinfect. Tang Lou uses a disinfecting brush dipped in disinfecting soapy water, and carefully and carefully first fingertips, then hands, wrists, forearms, elbows, and the lower half of the upper arm.

Brush both arms alternately.

After scrubbing for a full 3 minutes, rinse with water, with Tang Lou's beautiful fingertips facing up and elbows down, rushing from fingers to elbows.

"1...2...3!"

After repeating it three times, Tang Lou dried his hands with a sterile towel, folded it into a triangle shape, placed it on the wrist, and made the bottom edge of the triangle face toward the proximal end. The other hand held the two drooping corners of the towel and rotated to move toward the proximal end. , until the upper arm is ten centimeters away, then turn the towel over and clean the other hand in the same way.

All actions are standard. Washing hands before surgery is a kind of disinfection, more like a ritual, just like foreigners praying before eating.

Tang Lou understands that from this moment on, he is a real doctor who can face patients directly.

Taking a deep breath, I soaked my hands in ethanol.

After 5 long and anxious minutes, the whole set of actions was finally completed.

Stepping steadily into the operating room, Li Fan was already waiting for the battle, and Xu Lanlan and another assistant were waiting for the opportunity.

Seeing Tang Lou coming in, Li Fan nodded.

"Xiao Tang, I will perform debridement next, and you will suture. This patient's left arm was scratched by an iron tool, accompanied by high-speed liquid jet injury, and open soft tissue injury."

As Li Fan said, he was debridement for the patient.

"1% povidone-iodine solution!"

Li Fan ordered, and the assistant quickly prepared the solution and provided it. After 3 minutes, the sterilization was completed.

"Normal saline..sterile gauze"

During the operation, Li Fan completely lost the hip-hop look he had before, and was serious.

With his head lowered, Li Fan placed both hands on the patient's wound, starting from one point, continuously excised the skin at the edge of the wound in a circular manner, and then retracted the skin to completely remove the contaminated fascia tissue under the skin.

Another 5 minutes later, Li Fan finally cleaned up the source of pollution.

"Xiao Tang, the rest is up to you!"

According to Li Fan's evaluation, Tang Lou can do this kind of simple wound. Even if the suture is not perfect, it is such a critical moment. As long as it is not infected, it is already thankful.

Moreover, he will guide from the side, the worst case, at most it will be dismantled and re-stitched.

Tang Lou stood at the position of the chief surgeon, and his mind was inevitably agitated, finally waiting for this moment.

Taking a deep breath, Tang Lou glanced at Li Fan's lesion after debridement, and made a suture plan.

"Simple interrupted suture is generally used for suturing skin, subcutaneous tissue, muscle, fascia, peritoneum and other tissues, especially for suturing infected wounds or wounds with possible infection, which is convenient for timely suture removal and drainage without affecting adjacent sutures Wire."

While waiting for the assistant to take the equipment, Tang Lou said that he was giving Li Fan feedback that he was competent.

Li Fan nodded, Tang Lou was a bit more secure in his work.

"Simple interrupted suturing is simple and quick to operate; the tension of the suture can be adjusted according to the conditions of different wound edges during suturing, which has little impact on the blood circulation of the wound edge; individual suture breakage after surgery does not affect other sutures; it can be used in case of wound infection. Flexible suture removal and drainage.”

After Tang Lou discussed the advantages of the stitching method, Li Fan had already put down half of his heart.

It wasn't Tang Lou's reasonable and appropriate choice of suture method, but his clear head and calm mind when he performed the operation for the first time.

When I was on the operating table for the first time, I had practiced for almost a year. After going up, I was very nervous, and even the hand holding the needle trembled slightly.

All operations were performed under the guidance of the resident doctor. After the operation, I felt confused.

At this moment, Tang Lou looked like an experienced veteran with a calm judgment.

Li Fan couldn't help secretly applauding in his heart, some people are patriarchs who appreciate food.

Tang Lou controlled the needle forceps, and under the two-star suture technique, he was driven by his arms.

Steady and precise control of the needle thread with both hands, the needle passes through the skin, the epidermis, the dermis, and the subcutaneous tissue across the incision to the opposite side of the skin, and each stitch is individually tied.

Just like the rumors in the suture assessment, Tang Lou's sutures were even in length, the threads were arranged cleanly, and the knots were tied just right, with each knot being on a straight line.

"Really talented."

The more Li Fan looked at it, the more frightened he became. The biggest disadvantage of simple intermittent suture is that it takes a long time to suture and consumes more sutures. If the suture technique is not good enough, it may lead to misalignment of tissues.

But now under Tang Lou's precise control, the tissue incisions are perfectly connected, and the most amazing thing is that Tang Lou's movements are smooth and smooth.

His speed is really fast, fast!
It would take at least 5 minutes if you let yourself do it, but in Tang Lou's hands, the stitching was completed in less than 3 minutes.

"Doctor Li, I'm fine."

The assistant will take over the needle-holding forceps.

"Doctor Xiao Tang is too powerful."

Xu Lanlan was managing the equipment at the side, her beautiful eyes were full of admiration.

"Experienced stitching, smooth and fast, Xiao Tang, you did a good job. With this stitching speed and quality, we will definitely be able to treat a few more patients."

Li Fan praised from the bottom of his heart.

【Ding!The task grows rapidly, from suture (three stars, 9), to suture (one star, 1), 5/9.Complete the case 1/1, reward 1 gold coin, and refresh the card library. 】

Tang Lou looked at his panel:

Host: Tang Lou

Level 2: Upgrade 6
Operation column (2/2): Suture (two stars, 3), diagnosis (one star, 3)

Gold: 3
Bonds: inactive

Talent (1/1): Stitching Line

Storage Slot (1/9): Suture (one star, 1)

[Deck Refresh: Debridement (one star, 2), debridement (one star, 2), suture (one star, 1), suture (one star, 1), debridement (one star, 2) [-])】

Looking at the deck of cards and his remaining gold coins, Tang Lou froze for a moment. If he wanted to complete the task, he could just click on the suture technique.

However, looking at the debridement operation, I thought of so many patients in the corridor. Now there are only three doctors in the emergency department including the attending doctor. I am in the same group as Li Fan, and there are two other doctors. There are so many patients. Totally overwhelmed.

Interns who have some basic skills in suture surgery can still use it, but almost none of them can use debridement, especially in chemical plant explosions. In addition to being injured by hard objects, there are also liquid splash injuries, and even flame burns. Such a complicated wound infection , It is not something that ordinary interns can deal with.

Although some seriously ill patients have been sent to the city hospital, after all, most of the slightly injured patients have been sent to the Yu County Hospital recently.

The county hospital is really understaffed and stretched!
Tang Lou is hesitating, how can he suture without debridement?

"If the system is exchanged for debridement (one star, 2), can it help?"

[Drip, the patient is being scanned]

[Most of the infected wounds of patients are comprehensive injuries, and one-star debridement can only satisfy part of it, and it is not enough to support complex patients.However, if two-star debridement can be synthesized, it is enough to deal with all infected wounds. 】

"Doctor Li, two more patients have been sent to the emergency department. One has a cheek injury and is in a relatively critical condition. The other has a thigh injury that has injured a blood vessel and needs vascular debridement."

"Dr. Huang and Dr. Fan are already full. These two have been assigned to us. Both patients need to be operated on as soon as possible!" Xu Lanlan said anxiously.

"This debridement is more complicated and difficult to handle. I guess it's too late for me alone. I need to seek help. How is the surgery? They are the most powerful. You can ask."

Li Fan was also sweating on his forehead, and he was a little bit too busy.

Soon Xu Lanlan came back angrily with a bitter face.

"Dr. Liu said that they can't take care of themselves in surgery. Dr. Li is not skilled in medicine, but he has to solve it by himself." Xu Lanlan repeated angrily, "Although their surgery is also very busy, he still has spare time for his main treatment."

"This bastard!"

Li Fan naturally understood that Liu Tong was taking revenge on him for what happened yesterday, and he turned his anger into anger, but thinking of the two patients who were in danger, Li Fan took off his surgical gown: "Xu Lanlan, you are preparing for the preliminary work, I will go and beg him personally! "

(End of this chapter)