medical simulator

Shashi Eighth Hospital?A tertiary hospital with a Chinese medicine brand?

There were no characters. As for who Cai Dongfan was, it was beyond Wei Hong's cognition circle.

Wei Hong then asked: "Dr. Qin, do you have the whole process in your operation records? I want the real whole process."

"Yes, my colleague has already finished writing it, and it's in my medical record. I didn't tell you before that it's not good to be an axe." Tan Yuanwu hurriedly asked his uncle Zhuo Zhiyang to hand it to Wei Hong.

When Wei Hong looked at the operation records, he couldn't see anything.Surgical records do not pay attention to the process, but only pay attention to what has been done and how to do it, which is a written description.

However, when Wei Hong saw the last part of the operation record, injecting sodium hyaluronate injection into the flexor tendon of the finger, his expression flickered immediately.

I thought to myself, the co-authors of these two elder brothers simply don’t understand at all. They have read some literature, but they are only limited to the literature. It is controversial that sodium hyaluronate can benefit postoperative functional recovery.

However, Wei Hong and his research group agreed that this is grandstanding.

So after pondering for a while, he said, "Director Tan, is there any video recording of your operation?"

Tan Yuanwu shook his head and said embarrassedly: "Professor Wei, we are a small unit and don't have teaching video equipment. Besides, Director Cai is also an expert we invited, so it's not easy to video."

Wei Hong nodded, but he was disdainful in his heart. If the experts in the eighth hospital could be called experts, then it would be a mess.

However, there is no need to step on or flatter people.

He just said: "Doctor Qin, the situation is like this. The blood circulation of your fingers is smooth. It is estimated that there will be no problem when they grow up."

"However, we don't know the specific suture of the tendon. Even if I perform surgery, it will not improve the survival rate of the severed finger. On the contrary, it will increase the probability of necrosis and non-survival to a certain extent."

"You are a practitioner yourself, you should know that."

"If you are going to be admitted to our hospital and require surgery, strictly speaking, it is not replantation of severed limbs, tendon and nerve revision. Do you agree with this?"

"This is a one-stage revision surgery. Strictly speaking, it is not a therapeutic operation, but a cosmetic operation." Wei Hong said to Tan Yuanwu very solemnly.

If the surgery is performed for non-therapeutic purposes, it must be informed and agreed by the patient himself, and repeated notification is required.

Wei Hong didn't make it clear, and directly pulled the stage up. If his colleagues reported it, it would be miserable.Can't tell.

"Well, I know." Tan Yuanwu naturally knew too.

Wei Hong went on to say: "Okay then, you also have the results of the blood draw here. Let's do another electrocardiogram and draw a blood coagulation to ensure the safety of the operation. You should understand the cost."

"It's all right, Professor Wei, from what you said, I am a doctor myself, I am conscious now, and my uncle is here to testify for me."

"I am conscious and know the pros and cons of the matter, so I demand an operation!"

……

Although Wei Hong sent Tan Yuanwu to the operating room, he still felt uneasy.

One is that he seldom takes the initiative to take over such cases. The outer courtyard has done replantation of severed limbs, and his second-stage renovations are usually the second-stage renovations.However, in the second phase of renovation, there will not be many functions that can be restored.

Therefore, before the operation started, Wei Hong still called his superior doctor.

After explaining the situation, Wei Hong asked: "Professor Deng, Director Cai Dongfan of the No. [-] Hospital, do you know something about it? Is it appropriate for us to repair the replantation of the amputated limb?"

Deng Liangen, is Professor Deng's name, he frowned when he heard this: "Cai Dongfan?"

"I do recognize Cai Dongfan, but when will he have a limb replanted, why don't I know?"

"Did Cai Dongfan personally perform the replantation of this patient's amputated limb?" Deng Lianggen asked puzzled.

Wei Hong said, "That's what the patient said."

"Okay, then you guys start to do it first, and I will come to the operating room in person later. Then try to be cautious and say as little as possible." Deng Liangen said.

Hearing this, Wei Hong breathed a sigh of relief.

Rest assured, since Professor Deng Liangen knew Cai Dongfan, and was so surprised that Cai Dongfan would do replantation of amputated limbs, then he would feel at ease.

In this way, after Tan Yuanwu was put down by the anesthesiologist, the subordinate doctor disinfected the patient's lower limbs and spread the drape.

Wei Hong said: "Let's leave the more serious left hand untouched, and you can deal with the right hand with me first."

Several graduate students and professional doctors nodded one after another, and then surrounded them.

After getting dressed, Wei Hong sat down at the chief surgeon's position in person, then looked at the sutured skin after replantation of the amputated palm, looked at the level of the suture, and said in a little surprise: "See for yourself, you can suture to such a level. Is it?"

"Don't underestimate the attending and deputy directors or directors of lower-level hospitals. Although their education is not as good as yours, their surgical skills can hang you up and beat you."

"Such skilled skin sutures are called high-quality sutures. Look at the skins you usually suture, what are they called?"

"Also, don't you usually say that the suture spacing of the replantation of the severed palm is difficult to control? Take a look at others?"

After Wei Hong finished his lecture, he felt that it was a pity to pick up the outer suture, and then said: "Oh, such a good suture, that's all."

After finishing speaking, he turned his head and glanced at the anesthesiologist: "Mr. Anesthesiologist, is the patient under general anesthesia?"

"Well, this is an emergency department. Where is there a nerve block for him? He's under general anesthesia." The anesthesiologist on duty said indifferently.

Emergency surgery is all about safety.

After confirming that it was impossible for Tan Yuanwu to hear it, Wei Hong continued, "Let me tell you, the more basic the operation is, the higher the level is in fact in lower-level hospitals."

"It's like you guys. I'm asking you to get an internal fixation now. You probably don't know how to do it, and you haven't even seen a few of them. Why, because you haven't touched it before."

"Needless to say debridement and suture, our hospital does not encounter a few in a year. Such patients are all sent away by our general hospital."

"The first is that the total number of patients who have been hospitalized is not large. The second is that the surgeries they focus on are no longer simple debridement and sutures. Even the surgeries you have encountered since the beginning are at least complex fractures. Operation."

"That is to say, when you came to study with us, the lowest-level surgery you came into contact with was level III or even level IV surgery, and occasionally there was a little bit of level II surgery."

"However, don't forget that all surgeries, fundamentals and basic skills must be practiced well."

Wei Hong then sighed: "The decline of simple surgery is a trend, and even in the future, the level III and level IV surgery will be down."

"Replantation of amputated limbs is a Class III operation. It has already sunk to prefecture-level hospitals."

"Today, I just want you to take a look at what the hospital below is doing for replantation of severed limbs. We can also observe and learn together."

Then, after Wei Hong opened the skin layer to the subcutaneous layer, he saw the tendon layer.

After seeing the tendon layer, Wei Hong's voice was slightly taken aback: "Improved Kessler method of tendon suture."

A graduate student next to Wei Hong was stunned, and asked Wei Hong: "Mr. Wei, are lower-level hospitals already in such a state? Any prefecture-level city has already started to use the most cutting-edge tendon suture technology." ?”

Wei Hongdao: "Then what do you think? You have only read a few documents and seen some operations, and you think it's great? Now the documents are all public, you can read them, and others can read them too."

"Let me also tell you that the doctor who performed this operation has read a lot of literature, and even used sodium hyaluronate."

"However, the improved Kessler method is worth learning, but it is too early to catch the literature heat of sodium hyaluronate. Moreover, the suture port does not have enough tension. If there is no retraction like this, the tensile strength between the muscles is not enough. powerful."

"Just a little bit." Wei Hongzheng commented on the flaws in the suture process, and he demonstrated how to separate the muscles on both sides with tweezers.

But did not move.

Like the legs of a girl with yellow flowers, she refuses to separate.

Several graduate students and doctors looked at Wei Hong.

???

a little what?

Wei Hong rotated the tendon a little, and then re-selected a point of focus, using tweezers to separate the ends of the tendon, preferably to be able to stretch the sutures!

It's just that, after dividing it again, it still didn't move.

The corners of Wei Hong's eyes opened slightly, like the eyes of a tiger!

Hey!

It's not scientific.

A sodium hyaluronate player, why is the seam so tight?

Wei Hong said: "This doctor's suturing skills are not bad, but he made a common-sense mistake, thinking that the tighter the tendons are sutured, the better."

"You know, if the tendon is sutured too tightly, it will lose its own mobility, that is, the finger extension work of the finger extensor tendon itself."

Originally, in order to check the extensor tendons, the muscles need to be in a relaxed state, so the hand is in the functional position, that is, the fist state.This will facilitate checking the function of the extensor tendons.

However, when Wei Hong stretched the extensor tendon he pointed out to the 'students', he saw that the tendon he just stimulated immediately straightened his middle finger——

——/′－/)

——/——/

——/——/

——/′－/'——'/′－`·_

——/'/——/——/——/¨－

——('(——－～/'——')

————'——/

——''——_－·′

————(

----

Then Wei Hong discovered that the eyes of those students were like this.

^_^.

It doesn't seem to be what you said, Mr. Wei.

Then look at the hand, the rest of the fingers are still in functional positions, and the middle finger is raised up.

╭∩╮.

Wei Hong is feeling a little irritable at this moment, why does this thing seem to be a little unreasonable, can't explain it.

Under normal circumstances, tendon sutures should not be like this. At least the tendon sutures he saw would have some protrusions or bumps.

After all, the convex and concave are the 'cool point' of the tight fit and connection.

Can?

Then Wei Hong tried a few more times, and it seemed to be the same.

It seems that the tendon is poisonous, and it is against Wei Hong.

Finally, seeing that Wei Hong tried several times, he still pretended to fail again and again.

A graduate student couldn't help but picked up the thread scissors, and said sensiblely: "Mr. Wei, why don't we go straight to the operation. It's getting late."

"There's no need to look for something that's not right. We don't think it's quite right when we look at the stitching. At most, we can wait for Teacher Deng to come and ask Director Deng to explain it."

Wei Hong felt that what he said made sense. It was indeed getting late. It was estimated that the operation would end after midnight, so he nodded.

Never seen a tendon stitch like this before.

The graduate student snapped a piece of thread, but after the thread was cut, it seemed that the tendon only split a small opening, instead of directly splitting half of the opening as they imagined.

The graduate student didn't really believe in evil, so he cut another thread, click, click, the movement of cutting the thread was extraordinarily crisp...

I don't know how long it took, but finally Wei Hong led the talents to completely expose the stumps of the two tendons, and when they pulled the sutures, they almost tore the stumps of the tendons into a ball of wool!

This abnormality finally made Wei Hong feel that something was wrong, so he quickly stopped the operation.

Preconceived, the tendon suture performed by Cai Dongfan is a bad tendon suture, which made him fall into a rather panicked state at the moment.

This seemed to be different from what he had imagined.

At this moment, Professor Deng came in from the operating room.

Seeing Wei Hong and the others looking at each other face to face, you look at me, I look at yours, they are just looking at each other, neither talking nor doing anything.

One is the appearance of having nothing to do.

Then he stepped forward and asked, "What are you doing? Are you so leisurely?"

"Let me take a look, how is your surgery going?" The tone was kind, very accommodating, without any airs at all.

Professor Deng is not tall, and he is a little fat, with a fat belly and the faint smell of smoke coming out of the mask, which will never connect him with the giants of hand surgery in the province.

I just feel like a middle-aged man who is a little greasy.

"Teacher Deng."

"Master."

"Master."

Wei Hong and the others immediately stood up to clear the view for Professor Deng, and they were also afraid that Professor Deng would touch them and violate the principle of sterility.