Great doctor starts with adding points

Wu Xie didn't answer right away, and after turning solemn for a while, he said slowly: "Brother He Ling, this is just my personal understanding, and I don't know if it's right or not!"

"Chen Tao, who received the internal fixation device, was hospitalized in advance, so we knew in advance that there was scar tissue on the surface of his skin. The removal of the internal fixation device is the simplest and most direct way to expose the steel plate by incision. It is necessary to go deeper along the original approach.”

"Generally speaking, the most common complications during the removal of internal fixation devices are excessive blood loss, plate breakage, screw tooth slipping, or plate slipping wire, etc. Then, important blood vessels and nerves are accidentally cut. "

"The last possibility is very small, because this incision has been carefully considered by the surgeon when designing the surgical incision approach, so for me, the biggest challenge is that there is more blood loss during the operation."

"Although it may not necessarily cause the patient's shock, arrhythmia, etc., it will also greatly affect the vision."

"Brother He Ling, you also know that although the blood vessel density of scar tissue is relatively low, the elasticity of blood vessels in scar tissue is poor, and the internal structure of the tissue is tight and hard. The compression and stretching of the tissue during the operation will cause the scar tissue to rupture, resulting in Bleeding increased."

"After the previous operation, the local blood supply and nutrition of the scar were insufficient, and the local immunity was weakened, and bleeding was prone to occur during the second operation."

"Coupled with the aggravated inflammatory response in the tissue, blood vessel dilation and increased permeability, it is easy to cause local bleeding..."

He Ling listened and thought, looked at Wu Xie with complicated eyes, continued to stroke his belly, and was completely thinking about these reasons, I really didn't think so much about these reasons.

Ke also responded to Wu Xie and nodded slowly.

Then Wu Xie replied: "So I checked some literature in advance, which contains statistical data and anatomical structure reality. Scar healing after surgery is divided into three layers, namely the epidermis, dermis, and subcutaneous tissue."

"The epidermis, that's the main area of ​​scar formation."

"The dermis is made up of collagen and elastic fibers. Contains sweat glands, hair follicles, nerve endings, and vascular structures. The subcutaneous layer is the deeper layer."

"So I found out that in scar tissue after surgery, the depth of blood vessels from the skin varies from person to person, but generally speaking, the depth from the surface of the skin to blood vessels is about 2-3 mm. Therefore, in such cases, When we make the first incision with a round knife, we must be lighter. It is best to only cut the epidermis, not the dermis where the blood vessels spread."

"Using an electric knife to break open the dermis that is prone to bleeding should be able to slow down the bleeding as much as possible and facilitate my follow-up operations. It has just been confirmed during the operation that my thoughts and ideas are correct." Wu Xie explained with a smile. .

But in fact, the reason why he can control the surgical field so well is that his incision technique has been improved. The incision technique at the proficiency level allows him to easily grasp the depth of the skin incision.

If the feedback is good when your skills improve, then the entry of incision is to master the length of incision and the accuracy of incision, without bias, and then be able to properly control the length of incision.

The proficient level of incision technique is based on the entry-level incision technique, and can accurately grasp the depth of the incision, but Wu Xie did not tell He Ling this point, fearing that he would misunderstand that he was trying to pretend.

"Well, it can be seen that Xiao Wu, you have put a lot of effort into this operation, especially in terms of details, you have made more thorough preparations and thinking."

"However, I still want to remind you based on my point of view. There are many types and quantities of surgical operations. After you have mastered the basic skills, you should spend a certain amount of time to expand the types and quantities of surgeries you have mastered. Opening up the width is the benchmark for our hospital to better serve patients."

"Because he will choose the person who will be treated in our hospital. He won't care about whether the suture is good or not. He just wants to make it convenient and cheap. He doesn't need particularly sophisticated technology. It's like sharing it with others academically."

"It's not that you are not doing well now, it's just that you have spent a certain amount of time in a relatively unimportant direction, which is a bit of a waste of time."

"It's like this internal fixation device removal operation. Even if you directly cut the muscle open and close, and then remove the internal fixation device, the goal has been achieved." He Ling persuaded.

"Because the breadth of your services, to a certain extent, represents the volume of patients in the department."

He Ling is talking to Wu Xie from the departmental level, that is to say, Wu Xie does not need to provide particularly sophisticated technology, but to expand the service area so that Wu Xie can receive more patients, and then In terms of income and sense of gain, it is no less than that in the county hospital.

This is also Lu Junyin's confession to He Ling. At present, if the town hospital wants to keep Wu Xie, it has to consider Wu Xie's sense of gain to a certain extent.

"Okay, Brother He Ling, I understand." Wu Xie also nodded solemnly.

Although I don't fully agree with He Ling's point of view, the more patients in the department, not only the faster my growth curve, but also many benefits in other aspects.

He Ling looked at Wu Xie's serious expression, rubbed his belly again, and said with a smile: "Don't be so formal, this is just a casual chat. In fact, the patient's body size is regularly increasing in our hospital. reduce."

"For example, there will be more winter and summer vacations, some parents will bring their children to see a doctor, and other times will be relatively less."

"However, after a while, there will be more. You also know that October is the peak time for lower-level doctors to go out to study, and from November to the end of the year, doctors from higher-level hospitals come to our town hospital for counterpart support. golden window period."

"If our surgery can also come to a prefecture-level city hospital expert this year, then putting out their signboard will also attract a lot of patients to a certain extent. Then in the process, we can actually follow the tertiary hospital that comes to support us. Attending physicians, learn more about operations and treatment methods.”

"We usually come to town either from the attending surgeon of the State People's Hospital, or from the old attending of the prefecture-level central hospital and the People's Hospital next door."

"Xiao Wu, you have a good talent. Director Lu will give you more opportunities at that time, but Xiao Wu, you should take the initiative." He Ling explained to Wu Xie in this way.

When He Ling said that, Wu Xie's heart moved——

According to what He Ling said, then this is a great opportunity. The more outpatient visits, the more patients there will be in the department. If the beds in charge of him are full by then, even if there is no individual patient with a very high output like Lin Hua, he will be hospitalized. Your own knowledge points will also increase rapidly.

"Thank you, Brother He Ling, for your guidance. I see, and I will definitely try my best to get the chance." Wu Xieyi's eyes lit up, as if seeing his skill level rising like climbing a ladder.

"Sure enough, he is a high-achieving student. It is so bright to hear that there are learning opportunities." After He Ling finished speaking, he stroked Wu Xie's shoulder fondly, and walked towards the department together with Wu Xie.