After collecting the money, registering according to regulations, issuing a surgical risk notification form, and asking family members and patients to sign.
Li Jingsheng arranged surgery for him on the spot.
There are no other requirements before the operation. You need to shave your beard and brush your teeth.
For two thousand yuan, disposable toothpaste and toothbrushes were provided by the clinic.
The service aspect must be done well.
As he watched the young man enter the operating room, his stepfather chased after him.
"Please take your time!"
He only said one sentence to Li Jingsheng, his eyes full of sincerity.
"I will. Don't worry, you and auntie. You can sit outside and rest for a while."
Li Jingsheng deliberately placed a row of benches outside the operating room, which can seat six people in total.
Since it is an outpatient surgery, the sterility management is relatively loose.
Different from the operating room in the inpatient department, the management there is more strict. Patients are generally required to bathe and change clothes, and then the doctor or nurse will push the patient in.
Now, basically, after the procedure is done, the family members push the patient to the designated operating room door to wait.
After waiting in line, the medical staff will take the patient into the operating room.
Some surgeries require the patient to wear no clothes. Generally, the patient can go into the pre-anaesthesia room and ask the nurse to help take them off.
Especially female patients.
Sometimes when I meet some interns who want to save trouble, I will ask them to take off their clothes outside, put a cover on them and push them in.
I believe many female patients will find it difficult to accept this.
In fact, you can refuse.
Many people think that the operating room is sterile, which is not correct.
Even the best 100-level laminar flow operating room cannot be absolutely sterile.
It can only be relatively clean.
Li Jingsheng's clinic now has a dedicated operating room, which is strictly disinfected before each operation, and the operations during the operation are also performed in strict accordance with the standards.
This kind of surgery fully meets the requirements.
"Boss, what sleeping position do you want him to take?"
"Get into the supine position!"
Li Jingsheng only brought two people with him to perform this operation. One was Han Siying, who served as his medical assistant.
One is Munro, a full-time surgical nurse.
"Is local anesthesia okay?"
"absolutely okay!"
Li Jingsheng has already put on gloves and changed into surgical clothes.
There is no pre-anesthesia room in the operating room of his clinic, but there is a dressing room.
That's what happened anyway.
If he wants to build better, he must wait until he makes money later. I have to at least buy this yard before I would consider it.
Otherwise, when the lease expires and he is asked to move out, wouldn't the decoration of the operating room be in vain?
Decorating an operating room to high standards is not cheap.
The lowest ones cost 500 yuan/square meter, and the more expensive ones are infinitely more expensive.
The two laminar flow operating rooms built in the Second Hospital were built using the back molars.
It is conceivable that it is possible for him, a clinic owner, to build this kind of operating room?
After placing the patient in a supine position, begin applying drapes and then perform local anesthesia.
These are operated by Munro.
Li Jingsheng made a very wise choice by keeping her.
For this surgery, children generally require general anesthesia.
Then his clinic cannot perform this surgery.
Local anesthesia is sufficient for adults.
"Siying, open his mouth."
Li Jingsheng couldn't help but think of the time when he performed cheek abscess surgery on a female patient, and Tang Ping worked as both a nurse and a medical assistant.
At that time, the clinic was just starting up and everything was difficult.
The equipment is extremely crude.
Compared with now, it is so much better.
After using a hook to open the patient's mouth, you can clearly see the mass under the patient's oral mucosa.
"Pull away and hold. Munro, give me the scalpel."
Munro handed the scalpel to Li Jingsheng's hand.
He chose to cut the mucosa two to three millimeters from the periphery of the lesion.
The advanced cutting method allows him to easily grasp the depth of the cut.
You can really cut as deep as you want.
However, when encountering some cutting or separation that is as fine as millimeter level, it is still difficult for him to control it accurately.
Because this difficulty is too high.
It is estimated that you need to reach a higher level to be competent.
His current doctor level is that of a senior attending physician, and he still has more than 2,000 experience points to advance to the next level.
It's really not an ordinary difficulty to be promoted to deputy director.
However, he has been working hard to accumulate health points in the past few days, preparing to upgrade his doctor level by one level before participating in the skills competition.
You have to be at least deputy director level to be able to see it.
When the time comes, all the experts from major hospitals will come. The stronger he is, the easier it will be for the Second Hospital to win glory.
Last week, Director Zhong Hu found him privately and wanted to find him as a medical assistant.
Because Director Zhong Hu is indeed a bit miserable, and he doesn't have a capable assistant.
This is why Professor Wu poked his pain point last time and immediately made Director Zhong Hu so angry that he rolled up his sleeves and wanted to fight.
Everyone has pain points and shortcomings.
It would be strange not to get angry when someone exposes one's shortcomings in public.
After Li Jingsheng carefully cut open the oral mucosa of the patient's diseased area, he found that the disease affected the parotid duct orifice.
Immediately and carefully cut around the catheter opening.
Fortunately, he is now very good at sharp separation and incision, otherwise this operation would probably be messed up.
If after the operation, this young man from a mixed society is drooling every day, I am afraid that his clinic will be destroyed directly.
After careful inspection, no erythema was found.
The feeling is more likely to be benign.
Clinically, if erythema is found in the lesion, it is usually treated as a malignant tumor.
The incision needs to be enlarged and the resection site must be at least 5 mm larger than the lesion.
He separated the lesions bit by bit and then removed them.
The whole process seemed extremely calm.
When cutting the lesion, cut all the way to the buccinator muscle, and remove the entire diseased tissue.
At this time, a large defective wound appeared.
He was a bit confused about the treatment of the wound.
If you directly pull and suture, the patient's wound can be sutured, but after healing, it will be difficult for the young man to open his mouth.
Eating, talking, and yawning will all become obstacles.
Because his mouth can only open a little.
The main reason is that the lesion is too large, and after incision, a large wound is formed.
what can we do about it?
Li Jingsheng is a responsible doctor who not only ensures the effect of surgical resection, but also considers the patient's postoperative life.
This surgery should not affect the patient's postoperative quality of life.
"Young man, you have also seen the tumor that was cut off. It is very big. Now you need to suture the wound. If you suture it directly, you will have difficulty opening your mouth when eating and talking in the future. You can only open it a little. I have a plan here. , that is, a piece of skin is transplanted from your arm. Just blink if you agree."
Li Jingsheng asked the patients for their opinions.
The young man blinked in agreement.
In order to avoid postoperative disputes, Li Jingsheng recorded everything.
This was not his first time having a tumor removed.
But this is the first time for skin removal and skin grafting surgery.
Fortunately, the suturing technique is very good, and the incision and separation techniques are also very good, so this seemingly uncomplicated surgical operation can be completed.
If I had known that skin grafting was needed, I would have charged at least five to six hundred yuan more.
There is nothing I can do now, so I should just do good deeds.
Otherwise, wouldn't it become a black clinic by temporarily increasing the price on the operating table?
Li Jingsheng is not willing to lose a lot for a few hundred dollars.
First, the young man was given brachial plexus anesthesia, and then the skin removal was started.
The entire skin removal process was smooth and hassle-free.
The difficulty is quite high, especially the size and shape, which require good control.
After removing the skin, Li Jingsheng sutured the skin graft to the wound surface.
Fortunately, the skin on the inner side of the upper arm was taken. Otherwise, there would be no way to remove the green dragon on his hand.
Therefore, if you are not a promiscuous person, there is really no need to imitate others and get tattoos on your body.
Many people like the green dragon on the left and the white tiger on the right. They think they are powerful and domineering. That is just a child's idea.
He is really powerful, he dresses elegantly, and he can also control the life and death of others.
Without strength, tattoos from head to toe are useless.
It will serve no purpose other than to keep people away.
[You have successfully transplanted skin, suturing +1, square knot +1, and health +1000. 】
As soon as he repaired the patient's wounds, Li Jingsheng earned his second huge amount of 1,000 health points in history.
This made him extremely happy.
Once the skin is transplanted, it is not finished just yet.
There is also a more difficult operation, which requires wrapping the wound surface with iodoform gauze.
This is another technical job.
He gained a thousand health points, plus the 1,672 health points he had deliberately saved in the past few days, which was enough to upgrade to the doctor level.
In order to prevent long nights and dreams, he did not hesitate and spent 2291 health points on the spot to directly upgrade the doctor's level to deputy chief physician.
After the upgrade was completed, he actually felt dizzy.
This has never happened before.
He secretly screamed in his heart that it was terrible. If he had known earlier, he should have waited until the operation was over before upgrading.
Fortunately, the dizziness didn't last long.
After the upgrade, he was pleasantly surprised to find that his clinical medical thinking, including his understanding and understanding of pathology, medical science, and pharmacology, had been greatly improved.
This feeling is like suddenly changing from a poor student to an excellent student.
Before upgrading, he felt that the attending level was already very good.
Now I understand that every mountain is really higher than the other.
Along with this, his understanding of surgery, as well as specific surgical plans, as well as surgical prognosis and risks, have been greatly improved.
When he looked at the patient's oral wounds, he could even predict what they would look like after surgery.
What risks will you face in the three to seven days after surgery?
There are also some detailed issues that can be discerned or predicted in advance.
For example, the parotid duct is damaged during suturing.
Or the skin graft may become necrotic.
If the skin graft taken is too thick, or the wound is not completely hemostatic before transplantation, it may lead to necrosis of the skin graft.
It doesn't work if the skin is too thin.
Excessive shrinkage after healing can cause difficulty in opening the patient's mouth.
Taking the skin graft from the inner side of the upper arm, the thickness is moderate, which can be regarded as accidentally avoiding these risks.
"It turns out that this is the strength of the deputy chief physician. He is really strong. Even if his surgical ability is weak, his diagnosis and understanding of pathology and pharmacology cannot be matched by the attending physician."
Li Jingsheng was very satisfied after feeling the power of the deputy director.
The experience point requirement for promotion to deputy director is 5,000, a very scary value.
Under normal circumstances, being promoted to deputy chief physician at the age of thirty-eight is considered very powerful.
Moreover, although many young deputy chief physicians have been promoted in professional titles, their actual level is still far from that.
Li Jingsheng is not even thirty years old now, and he has already reached the level of a solid deputy director.
The Second Hospital offered a series of favorable conditions to admit him, originally because of his talent in bone-setting techniques.
I want to make my bone-setting business more stable and bigger.
Now that Li Jingsheng has reached the level of deputy director, he may soon give Director Hua, Dean Fu and others a big surprise.
In this city's skills competition, he will shine even more if given the chance.
It's possible to become famous in one fell swoop.
He packed and sutured the patient's wound with iodoform gauze, and the operation was considered a complete success.
Just when he opened the gauze bag, he received a 100-point health bonus.
For almost every first operation, it is easy to get high health rewards.
Of course, the most enjoyable part is collecting the banner.
Now he has a separate outpatient room in the Second Hospital, and often receives pennants from patients.
The vast majority of patients still know how to be grateful.
Humans are nothing but grass, so how could they not feel how kind doctors are to them?
"You will not be able to eat liquid food for seven days after the operation. During this period, you cannot eat."
After hearing this, the patient became anxious.
When he wanted to speak, Li Jingsheng told him not to rush.
"Come to the clinic every day for infusion these days, and I will give you nutritional injections."
Li Jingsheng quoted two thousand, which he felt was a bit low.
The patient's lesions must also be sent for pathological biopsy!
In addition to skin transplantation, it is not expensive to charge 3,000 yuan.
Forget it, just make less money from this business. The skin grafting earned him 1,000 health points, which was not a loss.
The patient's family background is very poor, and his mother can't even raise two thousand yuan, so she just does some charity.
Li Jingsheng took the patient out of the operating room and explained the precautions to the family again.
It seems like a not too big operation. If it is done in a larger hospital, it will cost seven to eight thousand, which is normal.
The inspection fees alone cost a lot of money.
You only spend 2,000 here and everything is covered, which is definitely a huge profit.
Now I just hope that the transplanted skin can survive.
Li Jingsheng will not be at the clinic for the next three days, and Dr. Shao and Tang Ping must keep an eye on it then.
Pay close attention to the patient's condition.
He prescribed medicine to the patient, starting with today's medicine.
The main thing is to use antibiotics to control the infection, and nutrient solutions.
He was confident in his suturing. As long as nothing unexpected happened, he should be able to take liquid food in about five days.
(End of chapter)
