medical simulator

However, Zhou Cheng didn't care about these, but after comparing the two titanium mesh shapes, he felt quite satisfied, so he took it to the operating table, and then said to Luo Yun and Cai Dongfan: "Mr. Luo, Cai Teacher, I have already done it here, let's fix the titanium mesh first, shall we?"

The debridement of patients has actually been done in the following hospitals, so there are not many debridement operations.

However, Cai Dongfan was not yet fully finished. He looked at Zhou Cheng, and then at Luo Yun, who was going to take the ilium autologous bone and make the fibula pedicled bone flap, and then started the ilium bone harvesting operation.

Looking at Zhou Cheng: "Should we let it go now?"

Zhou Cheng nodded, and said: "Now, through the fixation and shaping of the femoral bone marrow cavity and the femoral cortex, the femur can roughly restore its original structure."

"After the main body structure is restored, the fixation with the external fixation bracket will be more reliable, and it will be closer to the shape of the femur itself!"

Zhou Cheng had completely let go of this operation, and he didn't care about anything. Anyway, as long as Cai Dongfan dared to tell the truth, he would dare to show anything.

But if they can still give the patients reasons and opportunities to be released on parole for medical treatment, it can only be said that they are not strong enough!

The weight fell into the water, determined!

"Okay!" Cai Dongfan, whose scalp was tingling, didn't ask too much. Anyway, Zhou Cheng brought him more than one surprise, and Zhou Cheng's many operations and techniques had already surpassed Cai Dongfan's cognition.

But maybe, what I know is not the limit.

On the other side, Yang Yifeng immediately threw the phone into his trouser pocket, and ran out to wash his hands. He found that it was too aggressive for him to step down decisively and gracefully before.

This is another peak in trauma surgery, another thing beyond the ceiling.

This thing pierced into the deepest part of Yang Yifeng's heart.

He is interested and curious!

And because I was too anxious, the phone was not plugged in securely and dropped.

The itinerant nurse yelled at Yang Yifeng, "Dr. Yang, I lost my phone."

"Please pick it up for me!"

I didn't even look back.

Luo Yun also stopped taking the bones, and said to Zhou Cheng, "Wait a while, Yi Feng obviously wants to see it."

Then he said to Zhang Zhengquan and Du Yanjun, who were trembling and confused at the moment: "You two should watch carefully and study hard. Today's operation may not be repeated in the department for a long time."

"And such an operation, there are not many operating rooms in the country that can repeat it."

"The same surgery? I checked the literature casually, and the upper limit of bone defect bone grafting that is currently being performed is about 15cm!"

"There are not many opportunities."

Luo Yun knew that this was a super IV surgery. With Zhou Cheng's temperament, he would never perform the surgery again until he got the IV surgery.

Moreover, Zhou Chenglai should not be allowed to develop rashly, because Zhou Cheng's age and identity are still here after all.It has to be accumulated slowly.

However, in order for Du Yanjun and Zhang Zhengquan to serve snacks, he could only sell Zhou Cheng.

Similarly, these words were also addressed to Cai Dongfan, which means that it is better not to carry out such operations in the department. What Zhou Cheng has obtained now is only a level II operation authority!

Du Yanjun and Zhang Zhengquan immediately took a deep breath, and made an insignificant contribution to global warming.

Turning his head to look at Zhou Cheng, he felt that Zhou Cheng was extremely strange.

Zhou Cheng silently licked his lips with his tongue, without saying a word, he was in the state of preparing for the operation, waiting for Yang Yifeng.

Yang Yifeng's interest, the roundworm in his stomach, was hooked out by him, and he hooked it out on purpose, so he must be responsible for it!

After 3 minutes, Yang Yifeng washed his hands and went on stage. After using two pairs of gloves, Zhou Chengcheng began to put the titanium mesh on the inner wall into the bone marrow cavity!

Then after firmly strapping!

Zhou Cheng transferred the battlefield to the fibula again.

However, Zhou Cheng's bone harvesting process immediately made Yang Yifeng and Luo Yun feel fear!

The reason why the fibula bone flap can be called a bone transport material is because the bone flap can have a vascular pedicle, and it can survive after being transported and transplanted.

However, most people take the part of the nutrient artery in the middle and upper part of the fibula.

However, Zhou Cheng shaved off the entire fibula, and left at least six arteries around it.

???

Are there such arteries around the fibula?

Could it be that these arteries were pricked off by myself and others during autopsy or surgery?

Can so many blood vessels and pedicles be removed from the fibula?

Zhou Cheng saw the doubts of Luo Yun and Yang Yifeng, and also saw that they were forcibly suppressing the churning of children with too many question marks in their hearts.

My mind moved slightly.

Every subject, when it reaches the depths, most people will feel that they have become ignorant.What I know may not be the end.

Zhou Chengdao: "According to the existing anatomical reports, a normal fibula has an average of one or two nutrient arteries, and an arcuate artery has as few as three, as many as 3, and an average of about six."

That's all for this.

But this explanation is enough to enlighten Yang Yifeng and Luo Yun, but they are still frowning.

Cai Dongfan felt bitter in his heart——

Your own team?

Looks like his head?

Du Yanjun and Zhang Zhengquan suddenly realized.

Oh, there are so many blood vessels, so it's normal.

Unexpectedly, what Zhou Cheng said made Luo Yun and Yang Yifeng even more confused.

Because if there are so many arteries, where are they? What happened to two of them during the operation?

This is unbearable.

The more you learn, the more afraid you become, that's the reason.

Zhou Cheng didn't explain too much, and it wasn't the time to explain too much.

The pedicled fibula that was finally removed was split open to transport the bone flap. Although the split was split, Zhou Cheng did not hurt its blood supply structure!

This tiny operation immediately made Yang Yifeng, Luo Yun and others' scalps tingle again.

But they all agreed without asking too much.

It was agreed before, although it was not stated clearly, but everyone made it clear that Yang Yifeng was in charge of the intravenous filter and anesthesia, no one asked him if he would, and why.

Luo Yun is responsible for the reconstruction of the starting and ending points of the tendon!I don't ask Luo Yun the reason why he restores the starting and ending points.

Zhou Cheng is in charge of bone grafting.

Naturally, it is not easy to ask too many questions.

After the fibula was cut open, Zhou Cheng placed it on all sides of the titanium mesh, and then anastomosed the pedicled blood vessels with the arterial stump in the femur one by one!

After the anastomosis was completed, the clamp at the proximal end of the artery was opened, and the filling of the blood vessel was immediately seen.

The titanium mesh was stained with blood.

Comfortable!

That's right, ordinary doctors may be afraid when they see blood.I wonder if people will die.

But a real surgeon will be relieved when he sees blood.

Oh, the tissues here have blood supply and won't die.

Of course, except for the surging blood in the aorta.

-

Of course, it's not over yet.

Zhou Cheng continued to start the bone grafting of iliac crest autologous bone, and then used the low-cost bone grafting materials brought by the equipment dealer one by one around the fibula block, and then put the outer titanium mesh on the box .

A remodeled femur is done.

So unbelievably, it's done!

Then, Zhou Cheng continued to perform external fixation with external fixation brackets. The upper part was fixed at the position of the ilium, the upper part of the femur was fixed, and the lower part was fixed to the tibial tuberosity.

The intact ilium and tibia were used to securely fix the unstable femur, which completed the second step of the fracture surgery.

Just, the treatment of bone defects.

Reduction was replaced by bone grafting.

Fixed, internal fixation was replaced by external fixation bracket.

Treating the bone grafting of bone defects in this way is equivalent to learning to understand.

After Zhou Cheng finished, he was not proud. After carefully confirming the firmness of the upper and lower femurs, he stepped aside.

Immediately afterwards, it was finally Luo Yun's turn to play.

Luo Yun doesn't know much about trauma, but he understands joints. The composition of joints is not just the joint structure, but also includes the re-fixation of tendons near the joints.

After Luo Yun came up, he began to use Kirschner wires to make a tunnel in the bone, and then began to return the starting and ending points of the muscles one by one.

This operation is also like flowing water...

This also slightly touched Zhou Cheng's knowledge blind spot, and he suddenly realized it.

Oh, it turns out that muscles can still play like this?

Well, learned it!

Go to the simulation at night, if you don't get a good night's sleep.

The volume of surgery determines the lower limit of surgical quality, but cognition determines the upper limit of surgical quality——

Gradually not ignorance is the key to technological improvement.

...Outside the operating room, after hearing what Min Zhu said, Min Shi felt more and more wrong.

Then wait until Ding Meng leads people outside the operating room.

Min Shi immediately reacted.

It's just that after he understood, his expression became cloudy and he shouted: "No, no! Min Zhu, no."

"No surgery, no surgery."

"We demand that the operation be stopped immediately! We will not perform the operation." Min Shi began to shout to the operating room.

"It's a waste of life, everyone come and see!" Min Shi began to shout and make a scene.

It's just that it's useless for Min Shi to shout like that.

Before the operation begins, the family members have the right to decide whether to perform the operation, but once the operation starts, no one can stop the operation, except the operator.

This is the power that the law confers on the operating room and the right to surgery.

Once the operation starts, no matter whether it is the dean or anyone, it is impossible to enter the operating room and interrupt the operation.

As long as the chief surgeon does not allow it, even if you are a god or a top professor, it is impossible to interrupt the chief surgeon's operation.

As long as it is in the operating room and it says that he is the chief surgeon, even if he makes a mistake, it is impossible to forcefully interrupt it!

This is the rule.

What's more, Ding Meng was there at this time, so there was no need to call the police.

The security guard immediately came forward to persuade: "Sir, this is an operating room, please be quiet and don't disturb the operation of the patients inside, otherwise, it will affect the progress of the operation, and no one can take responsibility."

The operating room is a public area, even more special than the ICU, and any collision is strictly prohibited.

Trespassing and causing the death of the patient inside will have to bear a heavy price. First of all, other family members of the patient will not agree.

There were quite a few people waiting for the patient's operation to end, and someone immediately stood up and looked at Min Shi: "There is something wrong with you, you are yelling outside the operating room at this time."

"They're going to kill people, they're going to be butchers in white clothes. They're going to kill my brother-in-law."

"We asked to stop the surgery, we didn't do it!"

"I have the right to ask to stop the operation!" Min Shi continued to shout, hoping to save one or two more.

However, it was obvious that Ding Meng and the others didn't give Min a chance to try. He yelled at the door of the operating room like this, and he could be taken back and locked up for a few days on the charge of seriously disturbing public order, and he could still be educated.

No other reason is needed.