Great doctor starts with adding points

After a few people met so casually, they first moved to a small lounge.

Professor Duan Hong and Professor Meng Tang went to take a bath and changed their clothes before returning. The waiter served four cups of tea. After going out, Long Yuan pointed out to Wu Xie, "You should be polite anyway. You just said that, and Professor Meng didn't know how to reply."

"Senior brother, what you say behind closed doors doesn't have to be so high-sounding."

"And I'm here for the sake of connections. I can brag a little bit about myself, but I still think it's better to be straightforward first. On the contrary, it's more down-to-earth."

"Brother, don't you think I have a particularly dazzling reputation?" Wu Xie actually thought for a long time before saying this.

After hearing this, Long Yuan felt that Wu Xie was right.

You have come to beg for help, and you are out of relationship, and you still say some high-sounding words, but you feel that you are not grounded. You are so good that you create it yourself, so what is the relationship?

After a while, Meng Tang and Professor Duan Hong came to the small meeting room.

Professor Duan Hong smiled and said yes: "Professor Meng, you decide by yourself. I will be a peacemaker today, just to bridge the gap."

"It will definitely not make it difficult for you."

"Our hospital and Minda Hospital are universities for peer-to-peer exchanges, which belong to peer-to-peer assistance. In fact, Xiaoyu from Minda Hospital also communicated with us, and even applied to the hospital for us to send a teaching doctor in the past, but we all Haven't agreed yet."

"It will take three to five years for a hand surgeon to mature. If this is not done well..."

As soon as he came in, Meng Tang's voice gradually decreased until it was insignificant at last.

The counterpart communication between colleges and universities is a voluntary principle. In fact, the units that are being assisted naturally hope that as many people as possible will come, and after they come, they can be written into the history of the department as a kind of resume and achievements. Treated as 'performance'.

Of course, you can definitely learn a lot in this process, but not all doctors want to go to remote places. Isn’t it good for others to go abroad or go to better hospitals for exchanges?

There are actually very few people like Tang Yuewei who are willing to go to remote colleges and universities to communicate with each other.

"Xiao Wu, you are not an outsider. Your teacher and your senior brother have told me a lot of good things about you. I will tell you directly."

"Actually, I specifically agreed to two consultation operations in the afternoon for you today. You come with me. If you can satisfy me, then I won't say anything else."

"Don't worry, my request is not very high."

"But if you seem a little biased during this process, then we won't mention this matter."

"Smart people don't do useless work, and I hope you can understand my choice." Meng Tang said very straightforwardly.

I go to teach, yes, at most it is a hard trip, but you have to give me the charm of making this hard trip.

It's not that Meng Tang doesn't believe in Wu Xie's qualifications, but qualifications are qualifications, and accumulation and qualifications are not necessarily completely positively related.

This may be the result of a long-standing discussion between Duan Hong and Meng Tang, so Duan Hong didn't say much.

Long Yuan said: "Teacher Meng, let me go there with you, at least we can take care of each other."

Meng Tang immediately refused: "You go home and deal with your own affairs. I'll take Xiao Wu here, the two of us are enough, you don't have to follow."

"Professor Duan, after we had lunch, I will take you away as a student. I promise to send him back intact. You must rest assured about this, Director Duan. As for the others."

"I will also give you an answer as soon as possible, do you think it is okay?"

Upon hearing this, Duan Hong immediately said to Wu Xie, "Why don't you thank Professor Meng soon?"

Wu Xie immediately thanked him.

Because Meng Tang specially arranged two consultation surgeries, which are located around Han City, so it is not suitable to drink alcohol at noon, and the car to pick him up for surgery is already waiting outside.

After Wu Xie and Professor Meng Tang finished their meal in a hurry, Duan Hong and Long Yuan saw Wu Xie being led away.

After doing this, it is actually beneficial for Long Yuan and Duan Hong to speak.

"Master, Xiao Wu asked me to bring you some small things, which are not valuables. He asked me to tell you, and I asked in advance."

"Not much money." Long Yuan spoke for Wu Xie.

The selling price of Jiugui Liquor is not expensive, and the price of local camellia is also relatively favorable.

Duan Hong glanced at Long Yuan, and asked in a low voice, "What do you think of Xiao Wu during this time?"

Long Yuan gave a thumbs up: "I already have certain basic skills, professional logic theory, and the majors I am interested in are relatively solid, but in terms of overall perspective, there is still a little lacking."

"After all, the accumulated time is not enough."

"Physiology, biochemistry and pathology during the undergraduate period are only the foundation, and it is convenient for a specialist to have a more in-depth understanding. Xiao Wu has not yet dabbled in this aspect, so this will affect his learning speed to a certain extent."

"The simplest one, as you know, master, in terms of MRI reading, without a more solid knowledge of pathology and physiology, it is difficult to go to the next step."

"But Xiao Wu saw a dissection of these, there is no problem."

"In terms of operation, the accumulation is still not particularly sufficient. But Master, I found that Xiao Wu's thinking on a certain disease is very deep now."

"Master, do you remember the depth of thinking you talked about?"

Duan Hong nodded, put down the bowl and chopsticks, and signaled Long Yuan to continue.

"Just like in the field of surgical infectious disease, Xiao Wu's understanding of infection now simply goes beyond the level of operation, but he can let go of some things and serve a principle and experience."

Long Yuan was talking about Wu Xie's expert-level skills, medicine therapy.

All operations and medications are for the purpose of having sufficient medicinal effects. This level of knowledge is not something ordinary people can achieve.

This is like, in trauma surgery, Duan Hong’s current understanding of pelvic fractures is that everything is for normal walking, without deformed gait, and to restore the patient’s social function, not just to let him able to walk.

Restoring the patient's social function is to allow him to gain dignity, gain self-confidence, and gain a second life through exercise.

...

Wu Xie looked at his remaining knowledge points of less than two hundred.

After adding a little bit, it becomes.

"Nerve exploration, suture, repair, transposition (specialization 0/500)"

"Vascular exploration, suture, repair, transposition (specialization 0/500)"

"Finger, Limb, Toe Replantation (Specialization 0/500)"

Wu Xie has set the three major skills to the specialization level, mainly for the following considerations.

Professor Meng's level, Wu Xie's default in the field of hand surgery, is higher than that of Long Yuan. When facing Longyuan, it may be a skill at the proficiency level, which can further promote one's own learning and achieve the best output and input ratio.

But when facing Professor Meng, you must improve your access to prevent Professor Meng from asking any questions. He doesn't have his own experience, and then he can't answer. Instead, the other party doesn't know how to deal with Wu Xie. teaching carried out.

It is equivalent to that when your level reaches a certain level, you don't know how to teach students the basics.

Of course, as a professor, Professor Meng has rich experience in teaching masters. In fact, he will definitely be able to find an access point, but after all, it is for gaining more knowledge points.

Professor Meng Tang is not Longyuan, and he will not accompany him all the time, so he must achieve more efficient learning results within a limited time.

In the back seat of the business car, Professor Meng Tang and Wu Xie sat on one side.

Meng Tang took the initiative to ask: "The hospital we are going to has received two patients with severed limbs at the same time. One is a severed middle finger, and the severed part is at the second interphalangeal joint."

"Two surgeries are scheduled at the same time."

"One is the severed wrist joint. In addition to you and me, there will be one of my students operating in another operating room, and the two will be performed at the same time. Try to gain time for limb salvage."

"You know the holistic concept and treatment principles of limb replantation and severed finger replantation, right? Xiao Wu."

Wu Xie nodded. Even if he didn't know the relevant skills, he could memorize the principle from textbooks: "First deal with the broken bones, then polish the blood vessels and nerve beds, suture the muscles first, and then suture the blood vessels and nerves."

"The anastomosis of blood vessels and maintaining sufficient blood supply are the key to replantation of severed limbs."

This is a very holistic concept, which highlights the general principles and key points of surgery.

As a doctor who wants to get involved in hand surgery, this is the most basic, most basic and most important basic skill. If this preparation is not done well, then there is no way to talk about it.

"That's fine. Let's take a closer look later. The operating instruments and field of view of hand surgery are slightly different from those of conventional open surgery. You can experience the difference in hand feeling first."

Wu Xie was slightly taken aback when he heard the words.

But it suddenly dawned on me that my experience in operating orthopedic related instruments is now at a proficient level, so I don’t need to worry. The minimally invasive instruments of hand surgery and traditional operating instruments have the same origin, with only a slight difference. vary.

The car arrived at its destination quickly.

And because Professor Meng Tang was invited in advance, all the preoperative preparations have been done, and he is now in the operating room, and Meng Tang's student, Gong Yangming, has already gone to do the hemostasis of the amputated limb replantation, to avoid Excessive bleeding, leading to symptoms such as shock.

So, after Meng Tang and Wu Xie changed their hand washing clothes, they went straight to the operating room.

Because it was the weekend and only emergency surgery was performed, the two were quickly led into the operating room by the director of the orthopedics department of this private tertiary hospital.

During this period, Director Lin of the Department of Orthopedics naturally exchanged courtesy with Professor Meng Tang, but treated Wu Xie as a passer-by, and didn't even appear on stage.

"Xiao Wu, wash your hands and get on stage." Meng Tang called to Wu Xie.

This allowed Wu Xie to get a better assistant position. Then, at the official opening, Director Lin smiled and said, "Professor Meng, thank you for your support to our Aerospace Hospital."

Through these words, Wu Xie realized that this is the Aerospace City Hospital under the trusteeship of Tongji Hospital. The hospital accepts the surgery itself, but it does not perform the surgery itself. It basically relies on the professors in Tongji Hospital to come and support it.

Although I intend to go out to do surgery independently, but the current technical reserves are still lacking...

Professor Meng Tang didn't say much, but said: "Director Lin, let's quickly complete the key steps of replanting this simple severed finger, and let Xiao Gong take over later."

"Xiao Wu, stand opposite me and be my assistant." Meng Tang said, seeing that Wu Xie was pushed away again, he glanced at Director Lin and the others.

Everyone released Wu Xie immediately, and Wu Xie was standing directly opposite Meng Tang. At the same time, he began to calculate the plan of this operation based on his own understanding, and then based on his own plan, he understood the intention of Meng Tang's every step of the operation.

A tourniquet was placed on the upper arm in advance, so even if the blood vessel is severed in the middle near the surgical field, there is very little bleeding, and it has been solidified at this moment.

Although the principle of replantation of a severed finger is to deal with the fracture first, this is a major principle. Before dealing with the fracture, the wound must be debrided first. The necrotic tissue is repaired, and the retracted blood vessels and nerve stumps are found. Finally, the fracture is fixed with Kirschner wires or steel needles, and then the tendons, nerves, and blood vessels are sutured.

"How long has it been since you were injured?" Meng Tang and Wu Xie asked as they worked together to find the necrotic tissue that could be damaged.

The operation process is different depending on the time when the finger was severed. If the finger was severed for a long time, then the blood vessels will be sutured last. If the time for the severed finger is short, the blood vessel may need to be sutured first.

"According to the patient and his family's complaint, it has been four or five hours from now." Another doctor described it objectively.

"It's still early, first debride the proximal end of the severed finger."

"Xiao Wu, try to find the blood vessels and nerves on the far side to see if they retract." Meng Tang confessed, asking Wu Xie to help and test his basic skills at the same time.

With a simple operation, Wu Xie's basic skills can be tested.

The anatomy of blood vessels and nerves of fingers is the most basic skill of hand surgeons. It is very simple to know the shape of arteries, veins and nerves of fingers.

The middle finger artery and the nerve course refer to the proper artery and the proper finger nerve, which are on the side of the finger, also called the opposite edge.

The veins are divided into palmar veins and dorsal veins, which are located on the pulp and back of the fingers respectively.

After the finger is severed, the blood vessels and nerves will shrink into the muscle because they have lost their integrity, the same as some tendons.

After Wu Xie got the order, he did not use a scalpel to debride the wound, but used the hypothenar of his left hand to slightly fix the patient's fingertips, and soon Wu Xie turned over the broken end of the finger with a relatively small instrument. find it.

Soon, in about ten seconds, Wu Xie turned out the proper digital artery and digital proper nerve on the lateral side, the official term is the radial side.

Because blood vessels and nerves have a certain degree of ductility, after being retracted, they need to be temporarily fixed to find them again, which is equivalent to helping Meng Tang.

"Teacher, help me fix it." Wu Xie invited.

Blood vessels can be clamped temporarily with vascular clamps, but nerves cannot be clamped, and someone must help to deal with it.

But Wu Xie found this thing out so quickly, even Meng Tang who was opposite was slightly taken aback. Be thoughtful.

Director Lin, who was cooperating with Meng Tang, smiled embarrassedly and said: "Mr. Meng, this is your proud disciple again. I had a double eye on it before, thinking it was not the Xiao Dong I usually met, so I didn't care. Really. sorry!"

"Chen Luo, help me fix it." Director Lin didn't think it was very easy to find the retracted blood vessels and nerves so quickly and pull them out so easily!

Meng Tang blinked his eyelids a few times at Wu Xie, and continued with the operation...

There is another update at noon, so polish it.