Xie Wanying clicked the thread scissors in her hand to cut off the excess sutures.
The nurse opposite wiped the sweat from the surgeon's forehead again.
In contrast, Xie Wanying's face had been trained for most of the day, and not a drop of sweat fell down, as if it were a frozen object. The nurse and anesthesiologist glanced at her face.
It's impossible to say that she didn't panic. The teacher did not inform her in advance to prepare herself mentally, so she was a little panicked when she was suddenly asked to be an assistant. Xie Wanying admitted this. Even though she had seen the teacher as Issuke many times and knew what Issuke had to do, it still took some time to get used to it. Fortunately, her quick-response brain, along with her hands, adapted.
Halfway through the operation, the nurses and anesthesiologist breathed a sigh of relief. There were fewer snapping pointers in the operating room, and the scoldings were reduced to zero.
Near the end of the operation, the teacher gave her the opportunity to practice another suturing method.
Because the patient was thin and weak, the clinical teacher decided to use full-thickness decompression suture on the patient.
"Do you know how to sew?" Teacher Sun asked.
Xie Wanying quickly realized that she was in charge of the bed and replied: "Teacher Tan sewed three beds last time."
This student often steals his teacher. The single thin-lidded cold eyes under Tan Kelin's eyebrows were drooped. Only the pointer pliers he held in his hand was turning in his palm, which could slightly reveal his funny but indescribable mood.
"You probably haven't mentioned it much in your medical books." Sun Yubo recalled the textbooks he studied in the past.
How can textbooks compiled every few years keep up with the ever-changing medical developments. Often some knowledge in books is outdated and impractical once it comes to clinical practice. Otherwise, why have we repeatedly emphasized that medical students should have enough internship time before graduation?
Doctors are a practical technical profession, and suturing is not embroidery on books.
"Since you have seen Mr. Tan sew, you can try it." Sun Yubo answered without taking the test, knowing that the student in front of him was too good at memorizing and there was no need to take this test.
Xie Wanying could only nod, and kept reviewing the key points of knowledge in her mind.
The skin suturing she had practiced the last few times was one of the layers of layered suturing.
Surgery opens the patient's abdominal cavity and requires opening several layers of tissue to access the organs, including skin, subcutaneous fascia, tendons, muscles, peritoneum, etc. These opened tissues need to be re-sutured closed after the surgery is completed. In this way, one layer of skin is sewn, one layer of fascia is sewn, one layer of tendon is sewn, one layer of peritoneum is sewn, and so on, which is called layered suturing.
Full-thickness suture is different from layered suture. As the name suggests, it becomes a piece of suture with several layers of skin, fascia and so on.
The patient in front of me is malnourished. If the layers of sutures are sutured, it may not promote wound healing. Instead, it defeats the purpose of suturing, causing the body's exudates to fail to effectively escape or be absorbed, increasing the chance of infection. It is not as good as several layers of sutures. The sutures bring the tissues closer to alignment. The final healing depends on the patient's own tissue growth and has nothing to do with the sutures.
The principle of decompression suturing is the same. In emaciated patients with less fat, the sutures pull the tissues too tight, resulting in scar hyperplasia that looks like a centipede and is even more unsightly. Such patients often have high intra-abdominal pressure and tissue tension, and a severe cough can easily break the sutures. To do this, it is necessary to reduce the pressure on the incision and increase the distance between the needle entry point and the needle exit point and the incision, which is vividly called decompression suture.
Therefore, this patient was like a third bed, and even the peritoneum was not sutured.
