medical simulator

Everyone's eyes moved to the three of them again.

There used to be such a saying in the medical circle of Huaguo.

North Xiehe, Nanxiang University, Xihuaxi, East Qilu.

Even though Hunan University has already been left behind by Xiehe and Huaxi, the peak that Professor Song and Professor Xu led Hunan University to is something no one dares to ignore.

Professor Song, former director of orthopedics.

As early as when the various lectures and experts who are sitting now were still students, they participated in various academic conferences in the form of experts and speakers all over the country, and almost no one did not know them.

Under his leadership, the comprehensive strength of the Orthopedics Department of the Second Xiangda Hospital ranks among the top ten in the country.

As for Professor Xu, although he is not the head of the department, he is indeed the only one with a real reputation in the academic world.

Engaged in the research and treatment of bone tumors, osteoarthritis, bone tumor hips, and tumor knees, he has truly created a fortune in the field of bone tumors in Xiangxiang Province, and is also a leader in joint surgery .

Not to mention the articles he has published, but the books he wrote and the revised guide!

Even now, it is only fine-tuned on the original basis without major changes. He can be regarded as one of the founders of the bone tumor field in China. The neoadjuvant chemotherapy regimen proposed by him is still outdated even now. , is still in use.

The applause rang for a full 20 seconds, and before it fell, Professor Song and Professor Xu stood up and greeted everyone very elegantly.

Even though his hair and beard are all grey, his spirit is still strong.

However, Professor Kong, who was next to the old man, couldn't stand up because of his inconvenient feet, so he could only sit and wave his hands to the left and right to say hello, his eyes were a little lost and cloudy.

Then, Professor Zhuang introduced.

"Here, we would also like to specially welcome the person who really came from afar, the director of the orthopedics department of the First Affiliated Hospital of Xinjiang Medical University, who is also my family, Zhuang Zhou, Professor Zhuang."

"Professor Zhuang is the professor who is the farthest away from Shashi City among the experts invited to our Hunan Provincial Orthopedic Annual Meeting. It is really hard work to come all the way."

Professor Zhuang, whose full name is Zhuang Zhou, has the same name as Zhuang Zhou in ancient times, and is the chief director of orthopedics at the First Affiliated Hospital of Xinjiang Medical University!

At the same time, he is also a top expert in joint infection surgery. Today is also the first lecture after the opening ceremony of this joint surgery venue, and he will start it!

Enough to see his importance.

He was even one of the first people in the world to be able to advocate for joint infection, cleaning and joint replacement at the same time.

"Next, we welcome Professor Chen Jiwu from West China Hospital."

"We welcome..."

Professor Zhuang quickly listed a total of eight speakers with the same level as him, all of whom were chief directors of the Orthopedics Department of the teaching hospital.

It is also a character that only Professor Zhuang can invite.

These people have long been giants, and being able to be invited now is enough to show that the No. [-] Hospital of Hunan University has a deep foundation.

After all, if it was an ordinary teaching hospital, these people would not want to come.

"Once again, on behalf of all our colleagues in the Orthopedics Branch of the Hunan Medical Association, I welcome and thank all the experts for coming, to give and enjoy today's academic feast together!"

"Next, we warmly welcome Professor Zhuang Zhou to share his topic. The topic he wants to share is the perioperative assessment and treatment of hip joint infection or primary surgery for postoperative hip infection."

The topic is long, but extremely rigorous.

When Professor Zhuang introduced everyone, Zhou Cheng also listed today's speakers one by one in his mind...

None of the experts in the province specifically pointed out that today's foreign professor was invited.

Zhuang Zhou of the Affiliated Hospital of Xinjiang Medical University.

Professor of Joint Surgery, Affiliated Hospital of Sichuan University, Professor Chen Jiwu.

Chen Xueliang, a professor of orthopedics at the Affiliated Hospital of Seoul University in Hunan Province, is good at osteotomy orthopedics, which is a really difficult operation. This kind of surgery has never been performed in the Second Hunan University Hospital!

Kang Weihua, a professor of orthopedics at the Affiliated Hospital of Southeast University, is good at the diagnosis and treatment of joint tuberculosis, and is a benchmark in the field of joint tuberculosis.

The Ninth Affiliated Hospital of Jiaotong University in Shanghai, Professor Liu Yiping...

While Zhou Cheng was thinking wildly, the chairman of the meeting, Professor Lei Zhong, began to read Zhuang Zhou's resume as he walked from the audience to the speaker's rostrum.

"Professor Zhuang, doctor, doctoral supervisor, professor, National Natural Science Foundation of China..."

……

A series of suffixes made Zhou Changchang swallow a mouthful of saliva.

This is undoubtedly a top professor in a province.

This kind of private goods shared by academic conferences is definitely not something that can be heard in ordinary classrooms, right?

Zhou Chengcheng couldn't wait.

While thinking.

Professor Zhuang Zhou had already started his lecture, and Zhou Cheng immediately gathered himself up.

After turning over the title page of Professor Zhuang Zhou's ppt topic, a question came up.

"Joint infection, is it only the first stage of debridement and the second stage of replacement is the gold standard?"

"Maybe it was before, and it is now, but in a few years, maybe this standard will be changed."

"It should be changed to, for extremely special joint infections, the second-stage surgery is the gold standard."

"Since the 19s..."

Following Professor Zhuang Zhou's lecture, Zhou Cheng also noticed that even Luo Yun was quite serious, and his brows were slightly frowned, as if he was listening very seriously.

……

Chapter 185 So cool!

Joint infection is an eternal topic in joint surgery.

This situation is like infection after surgery. As long as surgery exists, the topic of postoperative infection will never be outdated, because in reality, bacteria and other microsomes are everywhere, throughout the treatment process, at any step , may lead to infection.

This is an established complication of all surgeries.

As far as a surgeon is concerned, it is inevitable that all his surgical patients will be infected, and it has not been encountered because the number of patients is not enough.

At present, the definition of the gold standard for the treatment of joint infection in joint surgery is one-stage debridement and two-stage surgery.

If it is a natural joint infection, it is the first stage of debridement, and the second stage depends on the situation to perform joint replacement, joint replacement, arthrodesis or other operations.

And if the infection after joint replacement is caused by surgery, then it is also the first stage of debridement, the bone cement and antibiotics are excluded during the operation, and the joint revision is performed in the second stage.

This is a relatively safe measure.

However, what Professor Zhuang Zhou said is that whether it is a joint infection that occurs naturally or a joint infection caused by postoperative infection, it can be thoroughly debrided in the first stage, and then the joint can be repaired in the first stage of surgery. Therapeutic treatment such as replacement or revision.

This is equivalent to merging the second-stage surgery into the first-stage surgery. In the past, this type of surgery is an absolute taboo! ~

One who treats conventionally understood contraindications as routine surgery, and even dares to talk about it.

First of all, I can only say that I am very courageous——

Because in the current guidelines, the gold standard for all infection management is the second-stage surgical treatment.

Surgery and treatment in violation of the guidelines are the right of senior officials only, and if there is a mistake, the person who leads the group or performs the operation must bear the responsibility!

Is primary surgery okay?

Of course, it not only saves the time of operation, but also allows patients to recover as soon as possible, and reduces their hospitalization expenses and medical treatment time.

But the risk is extremely high in the traditional perspective.

The standard treatment method written in the guidelines is to do two surgeries, one-stage surgery, which is time-consuming and costly. Once anything happens, the doctor will be held responsible.

Under such circumstances, the ability of the professor who dared to take such a risk and perform the operation against the guideline is naturally needless to mention.

This is a relatively new understanding and field, and it can also be said to be a new vision and concept, but it has not yet become a consensus...

There is still a long way to go to reach a consensus.

However, Zhou Cheng listened to Professor Zhuang Zhou's summary——

Professor Zhuang Zhou used a very formal summary——

take home messege (main points and summary):

This usually appears in more formal literature submissions, but Professor Zhuang Zhou wrote it in the ppt, which proves that he has already spent a lot of thought when making this ppt.

"Joint infection can be done in one phase, but there are a few key points that must be paid attention to."

"First, before the operation begins, we must find out the infection bacteria, and it is best to do a drug sensitivity test. If conditions permit, we can form a joint cooperation team with the laboratory department!"

"Second, there must be a time limit for sensitive antibiotics of sufficient length before surgery begins."

"Based on our experience, it is recommended that the premedication of sensitive antibiotics is generally 24 hours, and for limited conditions, more than 12 hours is enough."

"If sensitive antibiotics are not used before surgery, the duration of antibiotic use after surgery can be appropriately increased by 3-5 days, which can also reduce the chance of postoperative re-infection."

"Third, during the operation, thoroughly debride the wound, remove all infected tissues, clean the hidden spaces of infection, including muscle spaces, and intra-articular blind spaces. During this process, new spaces must not be opened!"

"Fourth, antibiotic carriers can be used appropriately during surgery."

"Fifth, continuous drainage after surgery. Those who have the conditions and are amazing can perform continuous irrigation and drainage."

"Sixth, sufficient amount of postoperative course, timely culture of drainage fluid and exudate, and timely adjustment of antibiotic dosage and duration. Routinely recommended postoperative antibiotic use time is 96-120 hours!"

"Seventh, proper postoperative rehabilitation training..."

"These are the photos before, during and after the operation of some of the cases we did. Please supervise me..." Zhuang Zhou was calm and relaxed, as if I came here to study, but in fact, he was full of emotions. It's all about showing off and pretending.

Hearing this, Luo Yun smiled a little, shook his head, then turned around and saw Zhou Cheng, holding a notebook, and carefully copied out all the words Zhuang Zhou said.

Then he asked with a flash of expression: "What are you doing?"

"I think what Professor Zhuang said is quite good, so I wrote down the notes so that I can think about it in the future." Zhou Cheng told Du Yanjun's remarks.

But in fact, Zhou Cheng felt that the new direction of joint infection treatment that Zhuang Zhou just talked about was tailor-made for him.

Isn't this a new breakthrough and perfection in the treatment of joint infection - a redefined realm?

Zhou Cheng even forgot the idea of ​​simulation, and directly took the idea that Zhuang Zhou just explained, and went to the simulation world once or twice, and he might be able to get the perfect—redefined skills, isn't that a good thing?

So Zhou Cheng naturally had to write it down quickly. As for the specific effect of what Professor Zhuang Zhou said, it still takes time to verify this sentence. Zhou Cheng didn't need to consider this factor at all.

The existence of the simulator is to give him a lot of opportunities for trial and error, as well as more trial and error time costs.

If it doesn't work once, I'll come twice, if it doesn't work twice, I'll come ten times, it's okay, that's three to five days.

Luo Yun's expression continued to be strange, he tapped Zhou Cheng's notebook, and said, "Didn't you see that everyone else just pretended to be Professor Zhuang Zhou, so let's listen to it?"

"Have you seen anyone who takes notes like you?"

Zhou Cheng followed what Luo Yun pointed out, and he didn't see anyone taking notes, and even many people had their arms crossed, their posture was not listening to the class, but watching the excitement.

After Zhou Cheng finished recording, he was listening to Zhuang Zhou's concluding remarks, and replied with a little distraction: "Mr. Luo, I'm also a stupid bird flying first."

Zhou Cheng feels that learning is personal, not common, and he is not someone else. Others are either associate professors, directors, or graduate students.

Associate professors or directors of other places do not need to study at all, and graduate students have their own better learning platforms!

Zhou Cheng himself did not have this opportunity, so naturally he could take more notes.

The opportunity to learn is precious and hard-won.

Seeing Zhou Cheng's seriousness, Luo Yun rolled his eyes and said, "You really take Professor Zhuang's pretentious words seriously?"

"Do you know, this Professor Zhuang, the reason why he dared to carry out the first-stage treatment of joint infection in his unit is that there are certain background factors in it."

"First of all, his affiliated hospital is Xinjiang Medical University, which is located in Xinjiang Province. Do you know that Xinjiang Province's medical insurance policy is excellent. Basically, such large-scale operations are completely covered by medical insurance. "

"That is to say, on their side, ordinary people's joint replacements are all paid by the medical insurance, and the patients themselves don't have to pay anything."

"So, neither the patient nor the doctor is afraid of having the joint prosthesis revised for the second time. The worst thing is to install another one. The patient does not pay for it himself, but suffers a little. He can bear it."

"But besides here, can you repeat this in any other place?"

"It can't be repeated, and this unique geographical advantage is the root of Professor Zhuang's daring to do these things. It's useless for you to take his notes."

"As long as Professor Zhuang has not changed his ability to change the guideline, and before he has received widespread worldwide recognition, what he said, in fact, is quite flashy fundamentally."

Luo Yun spoke so thoroughly that Zhou Cheng's eyes widened slightly.

And this thing?

Co-author, others just quietly let Zhuang Zhou pretend and force him to go through the motions, so he took it seriously?

Zhou Cheng has never had the opportunity to participate in such an academic exchange before!