medical simulator
Page 401
You have to do everything yourself.
With both hands, Zhou Cheng held tweezers in his left hand and a sharp knife in his right hand, starting from the skin incision, and slowly began to debride.
It's not particularly fast, and it doesn't have any unpredictable movements.
Shen De took a look, then smiled wryly.Then when he was about to make eye contact with Associate Professor Gu Zhongliang, he realized that Associate Professor Gu Zhongliang ignored him no matter how wink he was.
Then, Shen De turned his head slightly, and saw Xue Xiude who was performing the operation. At this moment, he also focused his gaze on Zhou Cheng's surgery field.
Actually—
Before Zhou Cheng made a move, Xue Xiude captured Zhou Cheng's movements very keenly. Although Zhou Cheng's sharp knife and tweezers didn't cut much necrotic skin, Zhou Cheng's right hand was floating slightly quickly.
Or dial...
The action looks like an intern doing the surgery for the first time, with nervous shaking of both hands, but.
However, this kind of jitter is absolutely different from that kind of jitter, very different.
Although Xue Xiude hadn't taken Zhou Cheng with him before, it can be seen from Zhou Cheng's operation of opening the sutures outside the surgical incision that Zhou Cheng had undergone surgery and was very skilled.
It is estimated that there are at least one or two hundred patients who have undergone surgery in his hands. Therefore, the nervous tremor like an intern's operation will definitely not appear in Zhou Cheng's hands, but now?
When Professor Xue Xiude looked more carefully, he could find that Zhou Cheng's right hand was shaking slightly, and the thumb, index finger and middle finger were constantly changing the angle slightly, controlling the tip and shoulder of the sharp blade, and quickly Scratch in the skin and subcutaneous space!
The principle of operation is somewhat similar to the curettage of benign bone tumors in orthopedics department!
Xue Xiude has always admitted that he is only a trauma surgeon, not an orthopedic surgeon, because he knows how big the gap is between trauma surgery and bone tumors.
Although he doesn't understand, as a professor, he may have more research on tumors than the general director of a prefecture-level city hospital.Because of the literature he has read, the research he has done, and the defense he has participated in, I don’t know how many...
However, bone tumors are usually inside or outside the bone, and they are relatively hard things. During the process of scraping with a curette, there will be feedback on where it is scraped.
The place Zhou Cheng is working on is only soft tissue. It is not easy to complete the scraping action in this place.
If the force is not enough, it is irrelevant. If it is heavy, the soft tissue such as muscles and blood vessels can be wiped out with one knife.
Amputation can be performed with a sharp or round knife, soft tissue can be cut everywhere, this is no joke.
"Xiao Zhou, who is this?" Xue Xiude asked immediately.
If you don't understand, you must ask.
Of course, he was also afraid that Zhou Cheng would do something wrong, although the chance of doing something wrong was very small.
There's no shame in asking questions.
Chao heard that, Xi can die.
If Zhou Cheng was messing around, he would have kicked Zhou Cheng out earlier.The reason why he still treats each other with courtesy is that Mr. Zeng's behavior is a bit unreasonable, and the second is that his students suddenly changed, which made him feel abnormal.
"Ms. Xue, I'm doing lacunar debridement."
"If that doesn't feel right to you, I won't."
Before Zhou Chengcheng said whether to do it or not, Xue Xiude shook his head, smiled and said: "No, you continue! And you have to continue."
"Of course, you still have to tell me a preliminary basic principle according to the procedure."
"After all, as the professor who leads the group, I have to give you a full account of all the operations you do. You have to let me know roughly what the worst result will be if you do this."
The Shanghai Ninth Hospital, as the affiliated hospital of Shanghai Jiaotong University, is one of the most well-known hospitals in Huaguo. If you can’t accept a new thing and don’t dare to tell the truth about a capable student, then it’s really a joke up.
However, Xue Xiude still wanted to ask Zhou Cheng, if he couldn't explain the specific principle, then he would feel embarrassed.
Zhou Cheng temporarily stopped the operation in his hands, and continued to explain: "It can be roughly divided into two parts. The first part is similar to the application of bone disease scraping and sweeping techniques in debridement. It uses micro-operations to achieve normal Muscle tissue and the ability to shave off dead tissue quickly and cleanly."
"The second part is the lacunar theory. Our conventional debridement mainly focuses on excision of necrotic tissue, and does not retain tissue that cannot be determined to be infected."
"However, I have always believed that the bacteria that infect patients' wounds are generally latent in various cavities. If these cavities can be resected in a limited manner by micromanipulation, the remaining normal tissues can be guaranteed to a greater extent."
"And it can clean up the infected tissue to a greater extent, reducing the chance of infection recurrence."
"Because according to the principle of normal debridement, the lacunae that can not be opened should not be opened as much as possible. However, we found through searching the literature that many experts at home and abroad have actually achieved complete debridement during debridement. The effect has been achieved, but there is still a recurrence rate of more than [-]%.”
"so……"
Zhou Chengxin picked it up and spoke skillfully.
Zhou Cheng, who has many perfect skills, can spark different skills with a little organization and overlap, and he can explain the principle. I borrowed the theory of bone tumor science, not out of thin air.
I also have literature and theoretical support.
Justified!
Xue Xiude nodded and said with a smile: "You can continue."
Then, Xue Xiude continued his operation...
Gu Zhongliang and Shen De continued to look at each other again, and the eyes that looked at Zhou Cheng began to reveal light slowly.
Zhou Cheng's ambition is big enough, he even thought about improving surgery, so why did he come to Xue Xiude?Isn't it good to go to Professor Yu Qiuhua?
However, it seems that this time, Professor Xue Xiude didn't mean to object too much.
The handwashing nurse stared blankly at Zhou Cheng for several times, first the documents, and then the operations of experts at home and abroad, as if it sounded like that...
Isn't it afraid of getting fucked if you boast such a big mouth all at once?
He looks so tall and handsome, it would be a pity if his eggs were lost...
Although the anesthesiologist had nothing to do with orthopedics, he had doubts about the authenticity of Zhou Cheng's theory, but he felt that Zhou Cheng's theory was a bit far-fetched.
Debridement and suture is the foundation of surgery, Zhou Cheng actually chose to start with debridement.
What is the basis of surgery, every medical student will tell you, debridement, debridement, or debridement.
The first step in the development of surgery is debridement, and the development of all surgical techniques cannot be separated from debridement.
Debridement is to teach the surgeon how to distinguish between necrotic tissue and healthy tissue. The essence of 90.00% of surgical operations above five is to remove necrotic tissue and preserve the patient's function.
It's just that basically all the techniques come from debridement, so this area, the development of surgery for more than 100 years, has basically been rotten and thoroughly researched.
Then you can still play tricks?
Of course, if you can really play tricks, then?
The foundation, what is the foundation, is the cornerstone of everything.
For example, mathematics is a tool and the foundation of various disciplines. If some theorems of mathematics come true, many things derived will immediately undergo earth-shaking changes.
Just like how long has the mass-energy formula been proposed, how much has human beings made in 100 years?
Medicine, every discipline, has two major experimental directions, one is called clinical experiment, and the other is basic experiment.
In clinical experiments, many conclusions or conjectures are not as influential as the results of basic experiments.Basic experiments are generally done in the laboratory, and once done, high-scoring articles can be published.
The reason why high-scoring articles can be published is naturally that the impact is a bit greater than clinical trials.
And some basic clinical skills, such as debridement and suture, have basically become bad street operations now. After graduating from a junior college, they can also know how to suture and some basic concepts of debridement.
At present, in the international arena, the basic operation in research is actually various fancy sutures.
Has anyone thought about doing something about debridement?
Yes, and many.
I really want to get my hands on it.
It's not that I don't want to, but it's too difficult.
So, if it is really possible to add something to the already outdated basic theory of debridement, then I'm sorry, big brother, you can't do it if you don't want to be famous.
You are all rushing to write conceptual things in textbooks.
Zhou Cheng's ambitions are not that great for the time being. Now, his theory is not particularly complete, and the theory needs to be transformed into data first, and then theorized from the data.
Don't be in such a rush.
However, Zhou Cheng's operation became smoother and smoother. He didn't perform the operation properly for some time, and it was already from the skin to the subcutaneous fat layer.
In the operation of the fat layer, Zhou Cheng has changed another operation mode...
When he saw this, he thought that he should be a very calm Professor Xue Xiude, and he couldn't calm down any more. He thought for a while, and then said: "Xiao Zhou, you have to suture this wound. For the time being, there are other things. opinion?"
Xue Xiude understood, and he heard it clearly.
It turns out that debridement can still do this?
It turns out that debridement can be reinterpreted.
Debridement, and a new understanding!
The re-understanding and interpretation of debridement, what is the concept in surgery, that is, Huaguo's characters, a new definition of initial consonants, finals and tones, if it can be achieved, then all concepts, It may all change because of this!
The foundation, though simple, is the cornerstone!
Even if this kind of thing that can change the whole orthopedics and even surgery is just a possibility, as long as there is a little sign, it can be done.
It is absolutely impossible for Xue Xiude to make Zhou Cheng give up.
Even if it persists for five or ten years, it is still useless, so what?
Zhou Cheng is still young, he can afford to delay, what if?
Zhou Cheng heard the meaning of Xue Xiude's words, but Zhou Cheng felt that it was a bit too hasty to take this debridement suture out as a topic, so he said, "There are some, but they are not systematic, Professor Xue. I am currently researching, It's another subject."
Zhou Cheng's words, like a pair of scissors, knocked out Xue Xiude's thinking.
Ga.
It is equivalent to cutting!
What could be more important than what Zhou Cheng said just now?
Xue Xiude felt that he had to find an opportunity to have a good talk with Zhou Cheng. Things had to be prioritized. Xiao Zhou, you are still young. In fact, the whole world you can see is just the tip of the iceberg.
Now is obviously not the time to talk, so Xue Xiude just asked one more question: "Xiao Zhou, what are you researching now? I think if it is not particularly important, we can still divide the research into priorities."
"Open reduction and internal fixation for fractures with small incisions, manual reduction and plaster external fixation for fractures." Zhou Cheng thought about it and said truthfully.
you.
Me? !
Xue Xiude kicked his feet and hit the egg.
It probably means that after the vastus medialis contracted too much, it pinched a bit, and it hurt a little.
Zhou Cheng didn't notice this at all, and continued with the operation on hand.
Chapter 244 Learning to Lick Dogs!
Xue Xiude originally asked casually, how could he have thought that Zhou Cheng could really reply to him?
Originally, Xue Xiude wanted to support Zhou Cheng, and hoped that Zhou Cheng would stick to his heart, work hard towards a higher, stronger, and broader goal, and never give up at will.
If the theory of debridement and suture can be subverted, then the foundation of surgery will also be subverted, and the benefits to the medical community in Huaguo are self-evident.
However, Zhou Cheng's answer to Xue Xiude later on——
Small incision fracture open reduction and internal fixation!
Manual reduction and plaster external fixation for fractures!
The two studies that Zhou Cheng presented were more down-to-earth than debridement and suture.
Among them, manual reduction and plaster external fixation of fractures is also a very basic skill.
Since the existence of orthopedic surgery, manipulative reduction has existed in clinical practice.Moreover, the current manual reduction of fractures has formed a set of very strict indications and contraindications due to the accumulation of decades of experience.
Among the contraindications of manual reduction of fractures are the surgical indications.
To make a breakthrough in this basic skill is to change the surgical indications of some types of fractures, which is also difficult, but yes, there is still a possibility. If successful, the disruptive effect will still be greater .
As for small incision open reduction and internal fixation, many clinical teams have proposed such a concept, and a small number of clinical teams have carried out and tried it.
Zhou Cheng's research on this is based on the existing foundation.
It is obvious that the possibility of realizing the latter two kinds of research is higher, more down-to-earth, and more down-to-earth.
Instead of believing that Zhou Cheng has a slight possibility of changing the foundation of surgery, it is better to believe that Zhou Cheng has the possibility of shaking the foundation of orthopedics first.
Xue Xiude also understood that Zhou Cheng came to the clinic this time with a purpose and a task, and Mr. Zeng's intervention was only a part of it.
Zhou Cheng wanted to carry out clinical projects with him, which was the real purpose.
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