When doctors have a simulated operating room
Chapter 130
The urethra is still open, and the urethra is still open.
While cleaning a large area, you must also pay attention to observing the urethral opening.
You must preserve the patient's excretion function and the outflow tract of cervical secretions.
You must also take a section of the most serious necrotic part in the middle and send it for inspection for tissue bacterial culture.
While cleaning, you must also explore the scope of the infection focus.
"My God, it goes straight from the ischial tuberosity to the pelvic floor fascia and then to the pelvic cavity, forming multifocal necrosis!
If this patient had come two days earlier, it wouldn't have been so serious!"
The doctor in the operating room sighed while cleaning.
Others nodded one after another.
He had to be infused in a rural hospital.
If he had come one day later, this person might have been in toxic shock.
Zhang Yi looked at Yu Jian standing in the corner and called him:
"Yu Jian, come here."
Yu Jian came over in response.
Zhang Yi picked up the gray necrotic tissue that had been removed from the curved plate.
"Describe the necrotic tissue."
"Ah?!" Yu Jian was embarrassed.
How to describe such a disgusting piece of rotten meat...
After thinking for a while, he stammered and described it:
"It's like... a rag with dust on it? Or... or the gray blockage in the sewer..."
"Disgusting?" Zhang Yi asked.
Yu Jian hesitated for a while and nodded.
Then he shook his head violently: "No, no, no, it's not disgusting. I'm a doctor, and I must overcome these."
"It's good that you understand. Go over there and put on gloves and observe carefully. This is the necrotic fascia. Take a good look at what the necrotic part looks like."
Ah? !
Yu Jian was petrified on the spot.
What you fear will come true!
Such a smelly thing, and he was asked to observe it himself...
Looking at Yu Jian's expression, Zhang Yi said:
"These are all experiences that can help you distinguish whether it is necrotizing fasciitis."
Yu Jian nodded quickly: "Okay, I understand, Teacher Zhang."
Although Yu Jian and Zhang Yi are not related.
But since he has become someone's teacher, Zhang Yi naturally hopes to teach a good doctor.
Fortunately, Yu Jian is the kind of student who is willing to learn.
If Yu Jian really got off work immediately in the department just now, Zhang Yi would not plan to teach him for the next month.
If he doesn't want to learn, the teacher can't teach him.
On the operating table, the cleaning continues.
While cleaning, rinse with hydrogen peroxide.
Because necrotizing fasciitis invades the fascia and skin, it does not hurt the muscles.
So the muscle tissue in the perineum and lower abdomen is fine.
At this time, in the monitoring room next to it, many doctors actually came one after another.
I heard that this is a rare large-area necrotizing fasciitis surgery.
And Zhang Yi was the surgeon!
Then we have to come and learn anyway!
Especially colleagues in general surgery.
If we can't get into the operating room, it's good to watch from outside.
In the surveillance video, Zhang Yi's movements are clean and neat.
It's as if he can directly find the necrotic lesion, and cut it one by one, and the necrotic tissue is removed cleanly.
Everyone looked at Zhang Yi's hands in the video with an expression of worshiping the great god.
Ah~
The great god's hands are not only slender and beautiful, but also so useful!
Look at my hands again, they are just useless~!
In the corner, Yu Jian stared at the gray tissue in front of him while observing Zhang Yi's operation.
Now he finally understood.
Why is Zhang Yi's work card not only a regular trainee but also a director's assistant?
Because Teacher Zhang is really amazing! !
Regular trainee may be fake, but the director's assistant is definitely real!
Yu Jian swore silently in his heart!
He will definitely learn well from Teacher Zhang during this month in the emergency department!
…
Another hour passed.
The necrotic tissue was finally cleaned up.
At least within Zhang Yi's field of vision, the necrotic tissue had been completely removed.
At this time, the entire perineum revealed normal red bloody tissue.
However, due to the large area of resection, a large area of the entire lower abdomen was also empty.
Next, grafting is needed.
Mark the intact skin on the hands or legs and cut it off.
Then graft it to the center of the lower abdomen in turn to fill the resected part.
Of course, the area of normal skin removed cannot be too large.
The tension of the remaining skin must be considered.
And
Skin grafting cannot be done in one go. You have to wait for the skin to grow.
You also need to apply gauze dressings with hydrogen peroxide and potassium permanganate to the wound.
Then add intravenous infusion and antibiotic treatment to ensure that the pathogens can be completely killed.
And the patient can only undergo a second skin graft if there is no recurrence.
The operation lasted more than three hours in total.
It's finally over.
The wound area is large, and he will definitely need to be hospitalized in the ICU.
He also needs a pain pump.
"Okay, send him to the intensive care unit first. The next skin grafting operation will be determined based on the white blood cell index and tissue recovery."
"Okay! Thank you so much today, Assistant Zhang."
The general surgeon nodded and looked at Zhang Yi gratefully.
Zhang Yi waved his hand: "It's okay."
"I'm a little embarrassed that this operation delayed your get off work."
Zhang Yi said politely: "What's the matter, it's all work."
He doesn't care about overtime at all.
The main thing is that this can not only practice, but the system can also reward money.
Why not do it?
After waiting for a while, the system has not rewarded yet.
Zhang Yi guessed that the reward should be given only when the patient is completely out of danger?
Wash hands and change clothes, and leave work.
In the elevator, several doctors who came to learn surrounded Zhang Yi and boasted.
Since Zhang Yi became the assistant director, more and more people have flattered him.
They are all people who know the times.
At a young age, he is the assistant director. Who knows what kind of big leader he will be in the future.
So it will be good to build a good relationship now!
At the entrance of the hospital, after the crowd dispersed, Zhang Yi glanced at Yu Jian and asked him:
"Did you see the necrotic fascia in the operating room just now?"
Yu Jian nodded: "I saw it clearly."
"Then did you learn my operation?"
"Ah? This...this I..."
Boss, I want to learn!
But how can I learn your operation...
Don't you have to give me some time...
Looking at Yu Jian's sad face, Zhang Yi laughed twice:
"I'm kidding you. Most people can't learn my operation. Remember, I will only teach you if you want to learn. If you don't want to learn, I won't teach you at all."
"I know, Teacher Zhang, I want to learn!"
A resident intern without a certificate can be the assistant director and get the respect of so many people in the hospital.
It shows that Zhang Yi is really amazing!
He must want to learn!
"You live in the hospital dormitory, right?"
Yu Jian nodded.
"That's perfect. Let's go eat together first, and then go back after eating. I'll treat you."
Interns don't have much money, so it's okay for Zhang Yi to treat you.
Yu Jian was overjoyed!
Oh my!
My teacher is so nice!
He is handsome and generous~
Yu Jian's admiration for Zhang Yi has increased a little bit!
Suddenly, the two people who had just walked out of the hospital were stopped by a female voice: "Excuse me, is this Doctor Zhang Yi?!"
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