My Medical Skills Give Me Experiences Chapter 128

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"It's useless to ask me about it. We have to listen to Dr. Zhou's own opinion and that of Director Shen."

Doctor Shan definitely didn't want to give up Zhou Can's talent.

Flatly refusing to offend Dr. Chi.

She cleverly kicked the ball to Zhou Can and Director Shen.

Under normal circumstances, Gui Peisheng himself does not have much say in who Gui Peisheng is with.

Gui Peisheng, who is less capable, has to go through the back door and give some gifts, so that he may be assigned to a slightly better teacher.

The people who really have the decision-making power are the department director, the deputy director and the chief physician in the department.

In order to save trouble, some departments will directly appoint a teaching team leader.

That person has a lot of power.

"Thank you, Dr. Chi, for your great love to me. A tree never forgets its roots, and a man never forgets its roots. If I had to choose, I'd better follow Dr. Shan."

Zhou Can has never been a person who forgets his roots.

Dr. Shan took good care of him, and he could feel the kindness.

For him, three months of training in orthopedic surgery was a short period of time. Follow an attending doctor who has a certain foundation of trust, and you can get more exercise opportunities.

At this moment, instead of choosing the more powerful Doctor Chi, he chose Doctor Shan, which would definitely deepen this trust.

"Haha, it's just a joke, Dr. Zhou doesn't have to take it seriously. I didn't expect you to be grateful."

After Dr. Chi tried it out, he saw that there was nothing he could do.

Laugh it off.

It can be seen that although there is competition within the group, it is generally considered united.

At this time, Director Shen has initially completed the construction of the bone interface at the implant site.

"Come over here and watch and learn carefully! I chose this position for the joint of the bones. The original thumb joint of his hand was preserved to the greatest extent. This is of great benefit to the recovery of finger function after successful surgery."

Zhou Can also stepped forward to watch and study carefully.

This fourth-level microscopic surgery has extremely high technical requirements in all aspects.

There is so much to learn.

"The problem of bone tissue docking has been solved. It is also necessary to solve many problems such as flap coverage, tendon, nerve, arteriovenous and vascular connections. In particular, this patient is congenitally deformed and has a missing thumb. Because after many years, there may be tendon, Constriction or loss of nerves and blood vessels."

This kind of operation has a greater unknown risk of intraoperative exploration.

The difficulty of surgery is also multiplied.

It is a great test for doctors.

"For the **** joint of the bone, you can refer to the replantation of the severed finger. Generally, the method of bone fixation is used."

Director Shen skillfully connected the bone of that toe with the phalanx of the patient's right thumb.

"In the future, if you encounter similar operations like this, you can judge based on the phalanx of the patient's hand. Like this, if the first phalanx of the thumb is intact, then the right big toe can be amputated. If the phalanx is seriously missing, amputation can be considered The ring finger next to the big toe."

Director Shen explained patiently while setting bones.

There are different transplant methods for different situations.

"Doctor Chi, the tendon reconstruction is up to you! If you don't understand, you can ask me anytime."

After Director Shen completed the bone setting, the inspection was correct, and he gave up the position of the chief surgeon.

Almost all surgeons only do the most critical part of the operation. The rest of the surgical work is handed over to other members of the surgical team.

This is why directors like to bring talented junior doctors.

Generally speaking, the better the talent, the higher the success rate.

After bringing the apprentice out, being a master can be much easier.

Especially for a major operation, the chief surgeon needs to complete it all by himself, which is almost unimaginable.

Physicians who are qualified to preside over third-level surgeries are at least at the deputy director level.

Generally older.

Their energy and physical fitness are no longer as good as those of the young boys. They no longer have enough energy and physical fitness to complete all the steps of the entire operation.

Let the disciples share their worries, this is the most ideal way.

Director Shen specially gave Dr. Chi the opportunity to exercise to rebuild the tendon.

It is also intended to cultivate Dr. Chi's surgical ability in this area.

After Dr. Chi took over, he began to look for tendons, and then tried to find a way to connect them.

When he encountered something he didn't understand, he asked Director Shen for advice in time.

Even Director Shen personally operated it.

Zhou Can stood by and studied silently. Some surgical skills and how to deal with various problems are very valuable core technologies. It is already a great opportunity for him to follow and learn.

Jin Mingxi worked desperately to be admitted to Tuya as a regular trainee, in order to have the opportunity to learn skills.

The operation lasted nearly four hours.

The difficulty is high, beyond imagination.

Finding and rebuilding the tendon is extremely difficult. In particular, the absence of the flexor tendon almost brought the operation to a standstill.

It is also extremely difficult to anastomose the nerves at the back.

Dr. Shan is very good at fine surgery. But meeting those nerves almost broke her down.

In the end, there were two nerves that had to be shot by Zhou Can, and the anastomosis was successful.

This is also because Zhou Can has a talent for neural anastomosis.

Otherwise, I'm afraid Director Shen will have to do it himself.

The subsequent vascular anastomosis is equally difficult.

It is too difficult to suture a blood vessel with a diameter of one millimeter under a microscope.

Moreover, there is also the situation that the sizes of blood vessels to be anastomosed are inconsistent.

These all need to find a solution.

The final flap, covered, was also fraught with difficulty.

Fortunately, the whole team worked together, stumbled, and finally completed the operation.

The next step is to bandage and observe the blood supply of the finger after transplantation.

After bleeding, the fingers and nails had a tinge of blood.

It's just that the overall look is still a little dry.

This is normal, and it will take a day or two, if the transplant initially survives. The color of the finger will become rosy, pale when pressed, rebound and quickly return to rosy after letting go.

This shows that the fresh blood in the capillaries is full.

On the contrary, there is a problem with blood supply.

Just like the patient who had replanted four severed fingers during the rounds in the morning, his fingers were pale and there was obviously something wrong.

It takes about a week to determine whether the transplanted finger is alive or not.

If after a week, the fingers are rosy, warm, plump, and respond well to capillary pressing, it means that the graft has been performed. If it turns black, shriveled, or even infected, it means the transplant has failed.

Must be dealt with immediately.

It must be said here that the sooner a necrotic limb is amputated, the better.

Otherwise, necrotic limbs or body tissues will produce a large amount of toxins, harmful substances, and bacteria, which will invade the human body along the blood.

At that point, whether he can save his life is another matter.

There is a city-level hospital that performed a lower limb artificial vascular bypass operation on a patient. During the period, the chief surgeon was on a business trip and was irresponsible in various ways. To the patient's appeal and response, he tried every means to prevaricate, and in the end the patient's high amputation failed to save his life.

Such a doctor who neglects his duty and regards the patient's life as a child's play should be banned from practicing for life.

But unfortunately, in this situation, the patient's family and the hospital filed a lawsuit. Usually get a compensation.

That doctor continues to wreak havoc on the world.

"Okay, the patient can be anesthetized!"

Director Shen said to the anesthesiologist.

"I'm going to the outpatient clinic in the afternoon, and I have to go to school. The two of you will lead the team to continue the operation. There will be other arrangements in this 100-level operating room in the afternoon, so let's withdraw! Everyone go to eat first and take a rest."

Looking at the two favorite generals, Director Shen made arrangements for them.

The professor with the group should be one of the busiest doctors.

Meetings, presiding over surgeries, ward rounds, teaching, doing research, attending classes, sitting in clinics...their time is often full.

From Director Deshen's level, everyone is a treasure in the Chinese medical field.

"Xiao Zhou, today's performance is good. I took a special look at the treatment and suture of the patient's foot wound. This kind of fish mouth suture is a very good choice. The suture technique and knotting are impeccable. You are in the emergency department. Who is your teacher?"

Director Shen's eyes fell on Zhou Can's face.

"Doctor Xu!"

In Zhou Can's mind, Dr. Xu is his only master.

Director Shen nodded, "I guessed a little bit. Dr. Xu used to be one of the three famous surgeons in our surgery department. With him teaching you, it's no wonder that your surgical ability is so outstanding. It is no exaggeration to say that you are now inferior to the attending physician except for your experience." , the surgical ability is not weaker than the attending doctor. Even some attending doctors with lesser surgical ability are far inferior to you."

This evaluation is a bit high.

But it's fair and true.

Zhou Can really has that strength now.

"Xiao Zhou, don't mind if you say something unpleasant."

Director Shen looked at him with sincere eyes and tone.

"Please speak, I'm all ears!"

Zhou Can knew that at Director Deshen's level, all he said was from the bottom of his heart and from experience.

That is to say, he is talented and his performance is extremely outstanding, so he is willing to tell him these things.

"When I saw you separating blood vessels yesterday, you had the shadow of Dr. Xu back then, and the style was very similar. Do you know how Dr. Xu fell from one of the three famous surgical knives back then to the current level of attending?"

"I know a little bit. Back then, Dr. Xu had a medical accident because he performed an operation on a patient, and was finally punished."

Zhou Can didn't know much.

"Back then, Dr. Xu almost killed the patient with one knife because his hands were faster than his brain because the knife was too fast during the operation. Later, the top chief physicians from multiple departments in the hospital tried their best to save him. The patient's life. However, the patient is permanently paralyzed and unable to take care of himself, just like a vegetable."

"The identity of that patient is not simple. At that time, this matter caused a lot of trouble. Originally, the higher-level authorities wanted to impose severe punishment on Dr. Xu, banning him from practicing medicine for life, revoking his doctor's license, and being included in the list of prohibited entry in the industry. Many leaders of the hospital, as well as a big man rescued by Dr. Xu, came forward to mediate with all their strength, which saved him."

"Your knife speed is too fast, which is very worrying. I'm really afraid that you will go down his old path one day."

Director Shen said earnestly.

"Your talent is stronger than any genius I've ever seen. As long as a talent like you is cultivated correctly, and you are diligent and unremitting in self-improvement, you will definitely have the ability to become the pillar of our Tuya in the future. As for the low education, then It's nothing at all, there are many ways to solve it. You can take advantage of this fast knife style just now, and the impact will not be too great. Stop the pursuit of speed blindly in time.”

It was really well-intentioned for Director Shen to try so hard to persuade him.

It is true that he loves talents, and he does not want to see a peerless genius go nowhere.

"Thank you for your kind words to me today. I haven't decided on Kuai Dao as the main direction of attack. It's just a preliminary practice. After one year of regular training, when I need to choose the main direction of attack, I will definitely weigh the pros and cons carefully. Choose carefully."

Zhou Can's current level of quick knife is just a glimpse of the way.

Even small achievements are still far away.

He also made an agreement with Dr. Xu, to practice and try first.

At that time, Zhou Can feels that it is not suitable, or the risk is too high. When faced with the choice of the main attack direction, he can give up at any time.

"Just listen to it. Through these two days of understanding and observation, I have a preliminary understanding of your ability. In the future, as long as I have an operation, you can participate with Dr. Shan. If you encounter medical problems that you don't understand Questions, as long as you are in the field of orthopedics, you can ask me at any time. But let me be clear in advance, I am proficient in the field of bone trauma and some microsurgeries. Joint surgery, spine surgery, orthopedics, foot and ankle surgery, I am all considered Not proficient."

Every doctor has a specialization.

Director Shen's specialty is the Department of Orthopedics and Traumatology.

"Thank you for cultivating me!"

Zhou Can bowed deeply.

Director Shen waved his hand, "I'm a more down-to-earth person, and I can avoid politeness if I can. Hurry up and go to dinner."

Through today's operation, Zhou Can's position in this group has basically been established.

His name is Gui Peisheng, and his actual status is almost equal to that of the attending.

Just look at the two special cares Director Shen gave him just now.

As long as Director Shen has surgery, Zhou Can is allowed to participate.

You can always ask him for advice if you have any medical problems.

This is the treatment enjoyed by two excellent attending physicians.

In the following days, Zhou Can began to hang out with Dr. Shan day by day.

Director Shen's operation time is uncertain.

He would spare time to preside in the operating room only for some third-level and fourth-level orthopedic trauma operations.

Whenever he presided over the operation, Dr. Shan would definitely take Zhou Can to participate.

Zhou Can especially likes to follow Director Shen to perform surgery.

Because you can indeed learn a lot of advanced surgical knowledge and skills. These are Director Shen's core skills, which are difficult for ordinary people to learn.

What's more, in Director Shen's operation, there are many opportunities to exercise.

From time to time, Zhou Can can always get some.

His orthopedic surgery skills are improving every day. Gradually have a more systematic and comprehensive understanding of orthopedic surgery diseases.

On this day, Dr. Shan performed another femoral head bone graft operation on the patient.

But it's simpler than last time.

This time there is no need to take a blood-pedicled bone flap. Just drill a hole directly on the femoral head, fill in the broken bone, reduce the intraosseous pressure, and promote the recovery of blood supply to the necrotic femoral head.

"Doctor Shan, can I try bone filling?"

Zhou Can is now very familiar with Dr. Shan, Dr. Tang and others.

In their small team, the status is not bad.

Many important surgical tasks can be fished.

It can be regarded as gradually breaking the ban of the quality control department that only allows him to perform first-level surgery.

This kind of thing basically belongs to the people who don't raise officials and don't investigate.

Zhou Can does have this surgical ability, and the superior doctor trusts him enough. It is his ability to get opportunities to exercise.

In theory, even if he participated in the fourth-level operation, he would not violate any laws.

The quality control department made a big fuss and had to talk about the quality and safety of the operation. Not allowing him to participate in operations above the first level is purely malicious suppression.

But there is no way, the emergency department is weak, and he himself has small arms and legs, so he has no way to compete with big bosses like Director Xie.

"The risk of bone grafting this time is relatively low, and the technical requirements are low. You can do it! I will guide you."

She made room.

Zhou Can was overjoyed. He insisted on playing with Dr. Shan at the beginning, which was the right move.

Various surgical tasks with high risk factors can often be obtained in her operations.

Such as separation of blood vessels and nerves, splicing of broken bones, internal fixation of fractures, etc.

As he filled in the broken bones.

Just finished.

【Congratulations on your bone grafting. Bone **** and bones can be transplanted to designated positions. This operation can repair broken bones, and can also save necrotic bones and help them restore blood supply. 】

[Bone grafting, the current experience value is 1/10 of the first level, and the level of practice is unqualified. 】

Looking at the newly added orthopedic surgery skill, Zhou Can felt very satisfied.

Now, he has learned all four basic medical skills in the Department of Orthopedics and Traumatology.

As long as he keeps improving them, he can become a qualified orthopedic surgeon.

As for other more advanced orthopedic surgery skills, we can only wait for the opportunity quietly.

Time flies, and before he knows it, he has been practicing in orthopedic surgery for more than two months.

The understanding of orthopedic surgery ~www.mtlnovel.com~ has a deeper understanding.

He discovered that orthopedic surgery and neurosurgery are twins.

Many orthopedic diseases and neurological diseases are like twin siblings. There are many major surgeries that Director Shen can't do by himself. He has to ask a neurosurgery doctor to do the surgery together.

Zhou Can's development in orthopedic surgery is quite good.

The basic medical skills of the four orthopedic surgeries have all improved dramatically.

Including bone grafting, which is difficult to improve, he has already been promoted to the second level, which is the lower level of regular training.

In more than two months, the total number of bone grafting operations was close to forty.

The quantity is not bad.

However, about one-third of bone grafting operations require the implantation of blood-pedicled bone flaps. This kind of surgery with a high coefficient of difficulty is usually performed by a single doctor himself.

What Zhou Can can get the opportunity to exercise is the bone graft surgery without blood pedicles.

Then, Dr. Shan still has two residents and two Gui Peisheng under him. It is impossible to give Zhou Can all the opportunities for surgical training.

On average, he was able to get 16 training opportunities for bone graft surgery in more than two months, which is considered very good.

From filling in broken bones at the beginning, to learning to take points and drill holes, and completing the whole bone grafting process.

It's been a very rapid growth for him.

Bone grafting is currently the one with the lowest experience value among the four basic orthopedic surgeries.

External fixation of fractures is currently at the third level, which is the lower level for residents.

This is due to his hard work.

After get off work, I went to the inpatient ward to collect work.

Someone wanted to apply plaster, and he happily rushed to do it.

After more than two months, a total of more than 170 patients have completed external fixation of fractures.

Chapter end