medical simulator

It may be that the patient's family cannot afford the money, or the patient is unwilling to be treated, or it may be that a small number of patients have an infection, which is very weird at all, and eventually develops into multiple infections all over the body, and finally loses their lives. Yes, it is possible to encounter.

In addition to Huaguo's traditional medical theory, which can cover 100% of diseases and has a super high "cure rate", modern medicine has always admitted its own shortcomings.

It's just that some people think that the reason why there is no one-and-done treatment in modern medicine is because of the operation and operation of capital.

Zhou Cheng knew that a person like Mao Yuxuan could openly admit that the Ninth Hospital of Shanghai had a disease that could not be cured. Just have to walk out.

Where is such a magical place?

……

Following Mao Yuxuan all the way into the operating room, Zhou Cheng is also familiar with the road, after all, he has been here before the Chinese New Year.

"Xiao Zhou, you have been in our hospital for a while, right?" Mao Yuxuan looked at Zhou Cheng's familiar movements, smiled and asked.

"Why didn't you think of coming to our trauma surgery department in advance?"

"Before, I was doing experiments along with it, and then mixed in the experience of sports medicine. And you know, Brother Xuan, that I am from Hunan Province. Professor Lin Ziyuan's senior sister Ding Dian is also from Hunan Province."

"It's almost because of this relationship, so I didn't come directly to our trauma surgery department."

To convince Mao Yuxuan, it is best to be truthful.Of course, don't be too real, otherwise, Mr. Zeng will lose face.

Mao Yuxuan didn't say much, it involved other departments, other professors, and other directors.He was always hospitalized, and he couldn't get in the conversation, and he wasn't even qualified to comment.

After going in and changing clothes quickly, the anesthesiologist is still administering anesthesia to the patient, and it will take a while before the operation can be officially started.

Both Associate Professor Gu Zhongliang and Professor Xue Xiude were not in the operating room, and Shen De and a follower were always hospitalized, that is, a doctor was watching in the operating room.

After Zhou Cheng and Mao Yuxuan arrived, they consciously helped to disinfect the towels.

The doctor in charge of the bed was still dealing with the doctor's orders upstairs. Zhou Cheng, Mao Yuxuan, and the resident inpatient's three major "inpatient chiefs" were the lowest-level doctors, especially Zhou Cheng and the inpatient's chief inpatient, Lin Yousheng, a third-year doctor.The qualifications of the two people are relatively low.

Although Zhou Cheng temporarily took Mao Yuxuan's position, he still gave Mao Yuxuan some face.Proactively begin sanitizing the drape.

After everything was done, Mao Yuxuan called Professor Xue Xiude and others up.

After coming up, Mao Yuxuan took the initiative to say to Xue Xiude: "Professor Xue, Xiao Zhou said that he has rarely seen such infection cases before. I thought about letting him take the stage today. Am I being lazy?"

This is called reciprocating, Zhou Cheng is willing to teach him that kind of miraculous fracture reduction technique, it is very reasonable for him to let Zhou Cheng participate in the operation of severe infection that he almost vomited.

Xue Xiude looked at Mao Yuxuan thoughtfully, his protruding cheekbones agitated a little, which caused the mask to rotate, but no sound came out.

Professor Xue didn't say anything, and it was even harder for Gu Zhongliang and Shen De to say anything.

To put it bluntly, like Gu Zhongliang and Shen De, the teacher is not Xue Xiude, and he is not a professor. The doctor who follows him is a professor with the title of professor, and he is staying overnight.

The things that should be managed are the things within one's own duty.For others, it is better to mix less.

A patient with a 5-bed patient after sinus resection, after returning to the ward from the last operation, there is a lot of exudate from the wound every day...

Xue Xiude and the others washed their hands, changed into sterile surgical gowns, and each put on two pairs of gloves before starting the formal operation.

Xue Xiude stood at the main knife position, Gu Zhongliang was the first assistant, Shen De was the second assistant, Zhou Cheng was left with the third assistant, and then his follower was hospitalized, and Lin Yousheng was left with the fourth assistant.

There are enough people on the operating table, so Mao Yuxuan has no place.But not being on stage has the advantage of not being on stage, but when I arrived at the best viewing position where the anesthesiologist was at the bedside, I started to look at it.

Mao Yuxuan was very familiar with the people on the operating table, but this was the first time he had seen Zhou Cheng, and he had never seen Zhou Cheng perform an operation.

Before disinfection, the gauze on the patient's wound was cleaned up. The patient's wound was a surgical wound of no more than 3-4cm, and there was a drainage tube wound below the surgical wound, but now no matter whether it is the surgical incision or the drainage tube , there is a small amount of pale pink cloudy liquid oozing out.

It looked like it was filled with pus.

In addition to being ugly, there is also a strange smell, a foul smell...

The patient had undergone surgery in other places before, and he came to Shanghai No. [-] Hospital for treatment after about half a year after the surgery.

Xue Xiude said: "For this patient, the sinus tract was connected to the right hip joint before. The first operation was intramedullary nail fixation of the femur. After the infection, the sinus tract was connected during the last operation. Right hip, but there was no pus pooling inside the hip, so I didn't clean the joint and the prosthesis."

"But I guess this time, it may be necessary to remove the prosthesis and debride the joint cavity together. Only in this case, the joint must be cleaned according to the incision of total hip replacement. Of course, this The access opening can be a little smaller."

The patient's sinus tract is located on the inner side of the thigh, and total hip replacement generally uses a posterolateral approach, which is two different directions!

After coming to the hospital, the sinus tract was cleaned and resected, and the sinus tract was naturally taken, because the result of the previous MRI showed that the sinus tract was a semi-blind sinus tract.

The intramedullary nail prosthesis is an inert metal that can be used for magnetic resonance.

Many prostheses today are materials that can be used for magnetic resonance, unlike the implants many years ago.

Before the operation, Xue Xiude discussed with Gu Zhongliang and others whether to open the original incision for joint replacement. After all, the sinus opening is too far away from the original incision.

The result of everyone's discussion is to open it and take a thorough look at the situation in the joint cavity.

Of course, the preoperative discussion of this operation was in broad daylight yesterday. At that time, Zhou Cheng had not yet decided to come to the department, so Zhou Cheng did not participate in the preoperative discussion.

However, now that Xue Xiude said so.

Gu Zhongliang suggested: "Mr. Xue, why don't we clean up the inner side first. Otherwise, when the joint cavity and the inner side wound are penetrated, and then the wound on this side is treated, there will be a lot of fluid accumulation."

Although Xue Xiude is a professor, Gu Zhongliang is still used to calling him Teacher Xue Xiude.

"Okay! That's fine." Xue Xiude thought for a while, and felt that it would be advisable to deal with the inner side first.

Although the last step still has to come to the inside, sometimes extra steps are necessary.Otherwise, the inner side is treated last, which may cause pus to pour back into the treated opening on the outer side, which will be troublesome.

Now the outer side is still a blind end, which can pass through the original sinus opening to form a certain degree of drainage.

Xue Xiude then looked at Zhou Cheng, then at Gu Zhongliang, and asked, "Xiao Zhou, can you deal with the inner sinus tract? If you can, I will deal with the joint cavity directly from here."

"Professor Gu? Can you help Xiao Zhou?"

When Gu Zhongliang heard the words, he immediately knew Xue Xiude's intentions.

When things go wrong, there must be demons. Mao Yuxuan suddenly turned his attention to Zhou Cheng, which is difficult to explain with common sense, so Xue Xiude wants to see what is weird about Zhou Cheng.

"Okay, Mr. Xue." The partial incision and debridement of this operation, for him, Gu Zhongliang, has no improvement and promotion. Doing less is rest and earning.

Get out of the way.

"Okay, thank you Teacher Xue."

"Then I'll give it a try." Zhou Cheng was slightly taken aback when he heard the words, and took only half a step back. Hearing Xue Xiude's words, he nodded impolitely.

In fact, he is also very curious, what is so difficult to deal with such a complicated condition.

This is the first time Zhou Cheng has encountered such a difficult situation, and it was an infection caused by a simple fracture operation.

He looked at his corresponding skills: [Debridement and Suture (Perfect - World Definition Level)]

What is perfection - world definition?

That is, the whole world is absolutely first-class, not to mention the first, it is definitely the best group.

This kind of debridement and suture is just a debridement and suture for simple trauma, but it is really a bit of a big skill.

But with great skill and small use, you can go to the end.

Cool is really cool...

Zhou Cheng agreed?

Both Lin Yousheng and Mao Yuxuan were a little bit stunned, because in fact, anyone with a discerning eye can see and should be able to hear that the conversation between Professor Xue Xiude and Associate Professor Gu Zhongliang just now has hidden deep meaning, and it went straight to look at Zhou Cheng Deep and shallow.

Zhou Cheng's most normal reaction should be to be humble, and then slowly plan for the chief surgeon.

I agreed when I came up, isn't it a bit rash?

If it is your own words?

Lin Yousheng felt that he must not dare to agree to the chief surgeon of this operation, because it has exceeded his ability, and it is undoubtedly boring to perform the operation on the patient by himself.

Make it harder for yourself.

Mao Yuxuan's heart was a little nervous for a while, and he was even more curious.

Zhou Cheng dared to agree, maybe it was rash, but maybe not.After all, Zhou Cheng cannot be inferred and evaluated with common sense.When I first met him, Zhou Cheng was very calm and confident.

Judging by Zhou Cheng's attainments in fracture reduction techniques, his debridement and suture shouldn't be particularly bad, at least it won't make things worse.

Therefore, Mao Yuxuan didn't open his mouth to explain anything to his teacher.

Shen De on the side looked expressionless, but when he saw that Zhou Cheng was not at all stage frightened in the face of such a complicated patient, his heart was a little tumbling again.

The complexity of this patient is not comparable to those patients with simple fractures encountered in the emergency department.

Are ignorant people fearless, or do they really have confidence?

……

Soon, Zhou Chengcheng took over the sharp surgical knife handed over by the equipment nurse.

Then, the outermost suture was opened, and at the same time, a saline pad was attached to the lower edge of the wound. The suture of the wound was opened, and then the inner suture was cut with a sharp knife, and the fat layer was discovered. Below, a large amount of liquid gushed out, very thick.

The color is an ugly thick yellow, and it is very sticky. Although I haven't smelled an unpleasant smell through the mask for the time being, I saw this sticky thing oozing out of my body, and I was a little vomiting overnight.

Shen De stood opposite to Zhou Cheng, as Zhou Cheng's assistant, very quickly inserted the negative pressure suction device in, and then:

"呲呲呲!"

"bububu!"

There was a burst of abnormal sound of turbulent air being partially blocked.

It can be seen that the liquid inside is indeed too thick.

Zhou Cheng watched as Shen De sucked away the viscous pus little by little, and then steadily picked out the sutures under the skin, including the sutures in the muscle layer one by one.

Then it was discovered that there was still a lot of thick liquid in the inner layer of the wound, even more than the previous fat layer.It's just that the color at this time is no longer dark yellow, but has become light green.

When Zhou Cheng was about to speak to remind him, he found that Shen De on the opposite side had not inserted the suction tube very forcefully.

Zhou Cheng also closed his mouth. Yes, standing opposite is Shen De, the attending physician of the No. , not as strong as myself.

However, never underestimate the other party's professionalism and foundation.

"Teacher Tour, bring me two bacterial culture tubes, and send me a general microscopic examination and bacterial culture, thank you." Zhou Cheng's voice was very decisive and calm, but very heavy.

If the entire cavity is filled with such a large number of bacteria, then the scale of this operation is not simple.

Extensive muscle compartment infection, muscle necrosis!

Moreover, it is a special infection. Although according to the treatment experience and the latest literature, the shortest period of anti-tuberculosis chemotherapy before surgery is only 2 days, but Zhou Cheng still feels that the period of anti-tuberculosis treatment before surgery may still be a bit short. up.

Of course, these are just Zhou Cheng's temporary thoughts on the disease.

After opening the sutures, Zhou Cheng was very restless in his heart, revealing pale white and dark red flesh-colored flesh of dead fish.

"Here, the culture tube!" After confirming the nature of the culture tube, the roving and equipment nurse handed it over.

"Thank you." After Zhou Cheng transferred the liquid in the wound into the culture tube, he resubmitted both to the equipment nurse: "One for quick microscope examination, and one for bacterial culture."

The itinerant nurse understands, and there is no need to explain too much.

They are all professionals, which will save a lot of effort and trouble, and allow Zhou Cheng to focus more on the subsequent surgery.

"Huh!" He exhaled, and then carefully looked at the situation inside the wound.

In the end, he decided to tilt his head and said to the tour guide who was about to send the culture tube down: "Teacher tour, please open another sharp blade as a spare."

Xun Xun was a little reluctant: "Didn't you open one? I just saw the one you were holding in your hand? Did you drop it?"

While asking, he still walked towards the spare instrument table in the operating room.

It can be heard that she said this only instinctively.

"Open a spare." Zhou Cheng returned without looking up.

The itinerant nurse was depressed when she heard that, so she drove the backup?What the hell reason is this?

The person is not big, the technology may not be very good, but the shelf is very big.

Of course, now that Zhou Cheng is the main surgeon, she can't say much.

Just complaining in my heart.

Xue Xiude had never had an operation with Zhou Cheng, so he naturally didn't know the magical effect of Zhou Cheng calling the roving nurse to prepare an extra sharp blade.However, sharp blades are not expensive, and they are not included in the conventional surgical consumables at all, so he didn't ask much.

Gu Zhongliang and Shen De also looked at each other in dismay, their eyes flickered, meaning to say.

Small things, small things, don't care about young people.

After Zhou Cheng called the roving nurse to prepare sharp blades, he told Shen De and Lin Yousheng: "Please use a little force. Expose the periosteum as much as possible."

Zhou Cheng believed that Shen De and Lin Yousheng could do it.

In fact, Shen De and Lin Yousheng quickly responded to Zhou Cheng, meeting Zhou Cheng's exposure conditions, although not so perfect, but such professional cooperation gave Zhou Cheng a feeling.

What exactly was the surgery I performed at the Eighth Hospital?