In terms of equipment, there are usually three commonly used separation equipment.
The first is various types of traditional scalpels.
It is a "cold weapon", but when it is used to separate some extremely difficult tissues or organs, blood vessels, and nerves, it has advantages that other instruments cannot match.
Many surgical experts call it a double-edged sword.
If you grasp it well, there will be various bonuses. If you don’t grasp it well, medical accidents are waving ahead.
There’s one benefit to practicing with a traditional scalpel that all surgeons go crazy for, and that’s the feel.
Nowadays, there are various electric knives and laser knives, which are very convenient to use.
But the sense of technology is too strong.
If you want to develop keen tactile feedback, only traditional scalpels can do it.
A powerful surgeon, he can tell the exact tissue that the blade touches with a single stroke, with his eyes closed, immediately and accurately. There are even surgeons who hold a knife and press it on the incision to know whether there are large blood vessels or nerves underneath.
This ability allows them to dance on the tip of a knife and perform all kinds of high-precision major surgeries with no disadvantages.
It’s just too difficult to develop keen tactile feedback.
Due to limited conditions, Li Jingsheng cannot afford an electric knife for the time being, not even the simplest and commonly used monopolar electric knife. Therefore, the only way to perform surgery is with a traditional scalpel.
Now is an excellent opportunity to practice separating diseased tissue with a traditional scalpel.
With skilled skin incision and superficial debridement as the basis, as long as he is careful, he should not overturn.
His mind quickly considered the gains, losses, and risks involved.
Then take another deep breath and make a decision.
Try to use an uninitiated sharp dissection method to separate the patient's sinus tract.
Regardless of success or failure, his separation technology will be greatly improved.
Practical combat is the fastest way to improve your skills.
He never fights unprepared.
Begin to recall in detail the many key points of the traditional scalpel sharp separation method.
"Vessels should be closed as much as possible before cutting!"
"The resected tissue must be fully exposed and identified, and ensure that the cut tissue is under direct vision during the entire cutting process to avoid cutting errors or overcutting."
“Tissue cuts using ligation or hemostatic clips should leave a stump long enough to avoid slippage of the ligation or hemostatic clip.”
…
Tang Ping did not rush him, but waited patiently for Li Jingsheng to perform the next step of the operation.
"Sister Tang, can you help me open the wound to both sides?"
"No problem. Use a retractor or just use your hands?"
"Use a flat hook! But I have to pay attention to the surgical field and ensure that I have enough pulling force when separating the sinus tract."
Li Jingsheng really had no choice but to let her take on multiple roles due to lack of manpower.
Retracting a hook is a physical job, and nurses are rarely called upon to do it.
They are all free intern doctors or trainees, who are called over to help pull the hook.
Unless the resident doctor is retracting the chief physician's surgery, he will rush to do it. The attending doctor's secondary surgery asked them to go over and pull the hook, but they were reluctant.
He was not interested even if some more capable residents gave him the chance to sew skin.
Because I have already mastered the technique of sewing skin.
Under Li Jingsheng's guidance, Tang Ping pulled open the incision on the patient's back, and blood came out again.
However, Li Jingsheng acted very calmly. After clamping a piece of hemostatic cloth and sucking it dry, he immediately began to devote himself wholeheartedly to separating the sinus tracts.
There are many reasons why he dared to do this.
First, the sinus tract is not deep and the risk factor is small.
Second, the sinus tract is very thin, so the area that needs to be removed is not very large.
Third, I have a certain degree of confidence in myself and am eager to learn a separation medical technique.
…
I saw him carefully cutting and pulling, bit by bit, separating the left side of the sinus tract from the healthy tissue. Then work on the right side.
Before each side is separated, he double-checks that there are no larger blood vessels.
In case of rupture, as long as it is not a larger artery, it can be saved.
But that would be trouble and the signboard would be damaged.
So a big risk needs to be taken this time.
To be precise, there are many unknown risks when a surgeon performs any operation, even the simplest first-level operation.
After working in this line of work, if you are timid, then go home and take care of your children as soon as possible.
In the words of the instructor, you must be bold and careful, study hard and practice frequently when performing surgery.
One minute on stage, ten years of hard work off stage.
Due to his efforts to separate the sinuses, they gradually separated from the surrounding tissues.
Although the incisions after separation were uneven, overall, it was an absolute feat to separate a difficult sinus tract in a patient for the first time.
Of course, the old man must not know this.
Otherwise, he would be so angry that he would demolish his small clinic.
Twenty-one minutes later, he successfully separated and removed the entire sinus tract. Throwing it into the plate, the old man raised his neck and took a look.
"Dr. Li, is that what caused the pustules on my back?"
"Yes, it is the culprit of the long-lasting pustule. Now it has been successfully cut off. Don't move, I will clean the wound for you and then suture it to stop the bleeding."
Li Jingsheng said to him.
After successfully separating the sinus tract, he felt that he had gained a lot.
Both mentally and technically, there has been a huge improvement.
It's not the time to count the harvest of medical skills yet. It won't be too late to check the changes in the attribute panel after the surgery is over.
He carefully debrided and trimmed the wound.
Then the original abscess cavity on the back was debrided and tidied up again.
Because this abscess cavity has been debrided many times, it currently looks fine and there is no new obvious infection. So just a simple cleanup is enough.
All the parts connected with the sinus tract have been removed.
After finishing it, Li Jingsheng took the time to suture the wound caused by the patient's sinus resection.
If it had been in the past, he would have sewn it as if it had been bitten by a dog.
And only entry-level continuous sutures or interrupted sutures can be used.
At this moment, he has learned four suturing methods, and all of them are at the proficiency level.
He seemed confident in suturing the wound.
The newly learned horizontal mattress suture can not only reduce wound tension, but also tighten epidermal blood vessels to help the wound stop bleeding. It is perfect to use it.
The proficient-level horizontal mattress stitch works pretty well.
The sewing speed is at least twice as fast as the entry-level model.
In addition, his knotting skills have also improved. Square knots, surgical knots, and slip knots are all at the proficiency level.
That’s a handy thing!
Just two words, so cool.
The wound was sutured for the old man, then the surface was disinfected, and gauze was applied to protect the wound.
"Okay, let me help you up. You can't leave now. You will need infusion later. Also, when you go home, you must protect the wound and keep it away from water. If it becomes infected and suppurative, it will be troublesome and may even be life-threatening. .”
The operation is now complete and was very successful.
Li Jingsheng also breathed a sigh of relief.
Give it a try and turn your bicycle into a motorcycle.
The successful completion of this challenging operation today is of great significance to him and the Sunshine Clinic.
At the same time, it also helped the patient solve a big trouble.
The surgery can be done well, but post-operative care is also very important.
There are many unpredictable risks when a patient cannot be hospitalized and managed.
For example, the patient did not listen to the advice and drank two sips of wine when he got home and was happy.
Or if the weather is hot and you want to take a bath, etc., all your efforts may be wasted and have extremely serious consequences.
Li Jingsheng must make the consequences more serious to scare the patients away from messing around.
"I won't touch the water. I promise not to touch the water. Even if I stink and have lice, I won't touch the water. Is it okay to wash my face?"
When the old man heard that water on the wound could be fatal, he was so frightened that his face changed.
He quickly expressed his stance that he would not get wet.
"Wash your face and hands, it's not a big problem. But you must be careful not to get water on the wound. Also, if the weather is hot, use the air conditioner at home to prevent sweating on your back."
Li Jingsheng helped the old man out of bed.
Didn't dare to let go.
The patient was in his sixties, had just undergone surgery, and had been lying down for such a long time. If you stand up suddenly, you can easily fall.
Within the clinic, he must be responsible for the safety of his patients.
"Can't you even sweat?"
"Definitely not. Sweat is the most likely to breed various bacteria. If it gets on the wound, it will most likely cause infection. When I used to work in a large hospital, there was a patient who refused to listen. In the end, our doctors and nurses rescued him together. I couldn’t save him even one night.”
Tang Ping said that she has a nose and eyes.
I have worked with Li Jingsheng for a long time, and the two of them can handle patients or customers at the same time, which is really excellent.
"Oh, it's so serious! Thanks to you for reminding me, I will definitely pay attention."
The old man seemed to cherish his life very much.
Think about it, with a high retirement salary every month, your life is comfortable.
He definitely wouldn't want to die.
"It is not recommended to go out at the moment. If you get caught in the rain or pushed by someone, the risk is very high. The sinus tract in your back has been cut. If nothing happens, just cooperate with the treatment and pay attention to nutritional supplements. , it may take less than half a month to recover.”
Li Jingsheng also knew that if the old man stayed at home for a long time, he would definitely not be able to hold it in any longer.
Given a deadline of half a month, the old man thought it would be over if he endured it.
"Sure, I just stay at home, watch TV, and tease my myna."
The old man happily made the choice that was best for him.
Opening the door to the treatment room, the old lady walked anxiously back and forth N times outside the door. Her eyes turned red when she saw the old man being helped out by Li Jingsheng. But after seeing that the person was okay, a happy smile immediately appeared on his face.
"Dr. Li, is the operation done?"
"You gave me such a big red envelope. If it didn't work out successfully, wouldn't I be so sorry to you! Now that the operation is over, the property has returned to its original owner. How much did you give it to me? Now it will be returned intact. Here you go."
Li Jingsheng performed the operation successfully and was in a good mood.
Smiling, he returned the stack of cash that the old lady gave him intact.
When the old man saw this situation, he was stunned, and then he understood everything.
He didn't say anything, he just looked at the old lady, just like a young man in love looking at his beloved girl.
It's like it's stuck with glue.
Men generally have deep feelings and are not good at expressing them, but they like to express them with practical actions.
"No, no, no, no, this is what I am willing to give to you. Now that the operation is successful, I feel that the money is well spent." The old lady glanced at the old man with a guilty conscience.
She was probably afraid that the old man would blame her for secretly sending red envelopes to Dr. Li.
But when she saw the old man's dreamy eyes, she immediately felt confident, and it was even sweeter than eating honey.
