Zhang Fan arrived at the operating room, and the director of anesthesia just came out of the office. When he saw Zhang Fan, he smiled bitterly.
"Yuan Zhang, that fat man's patient in the orthopedics department is too troublesome!"
"What's wrong?" Zhang Fan asked curiously.
"You'll know when you enter the operating room later. I won't talk about it for now. You just called me and asked me to help lift someone."
"Okay, you go first, I'll come back after changing my clothes." Zhang Fan nodded.
The head nurse in the operating room specially made a small dressing room for Zhang Fan. Although it was not big, it had a small sofa and a small table.
Change into hand-washing clothes and wear a hat and mask.
The hand-washing gowns in the hospital look tattered because they are made of pure cotton, and because of the frequent high-pressure and high-temperature disinfection and frequent soaking in disinfectants, but they are very comfortable to wear.
Because it is made of pure cotton, it will not be like some century-old high-quality clothes, which are full of static electricity and crackle when you walk.
When he walked into the operating room, Zhang Fan almost laughed. The fat boss suffered a ruptured Achilles tendon in his right leg.
Only the right side of his pants was taken off, and the white fat of his legs hung on the edge of the operating table, like unsmoked fat hanging on the wall beams.
Hua Guo's operating beds, in the early years, there were some products from Modu in the hospital, with the nameplate: Modu No. 3 Surgical Instrument Factory.
I don't know why, it's probably because they can't make money or have too little money, so they look down on it. In the mid-to-late 1990s, Huaguo products were launched in the medical market on a large scale.
The old-fashioned operating table is very thick. If you want to move the operating table, you don't need about twenty strong men to move it.
Most people really have no idea what an old-fashioned operating bed looks like.
It’s not easy to explain, so I can only say it briefly.
Older people, I wonder if they still remember the state-owned barbershops back then.
There are several aunts inside and some very comfortable chairs.
There is a big iron lump under the chair, and there are various magical gear levers around the chair, which can be turned and folded down to use as a bed.
Put this kind of chair at the back, and it is actually an operating bed.
The earliest surgeons were all barbers. Therefore, many things in operating rooms in the early years were very similar to those in barber shops.
Even now, the three-color rotating logo hanging at the entrance of many barber shops actually represents arteries, veins and nerves.
The products of the No. 3 Instrument Factory in Modu were eliminated by Class 3A hospitals just a few years after entering the 2000s. Because Maruko Country and Germany have developed new operating beds.
Their operating beds have all been automated and remotely adjusted. And because it has a battery, it can be used as an electric vehicle at critical moments.
This function may seem useless, but in a pinch, it can save lives.
Things in Wanzi Country are very stingy. The bed is not expensive, but there are many extras, and the total price is sky-high. One surgeon costs millions!
But because there are hospitals in developed cities that support their counterparts in the west.
The operating beds in Chasu City Hospital are relatively advanced and are made from Germany.
However, even after the extension panel of the operating table was opened, part of the fat boss's body was still hanging on the edge of the bed after he lay down on it.
"Zhang Yuan! We can only place a small table under his feet.
However, the height cannot be adjusted, which may be tiring after surgery. "
The head nurse was also helping. After seeing Zhang Fan, the head nurse straightened her back. It was too troublesome to bend down because... Wang Wang Wang definitely didn't understand.
"Okay, let's put a suitable table." Zhang Fan had no idea. The operating table can be adjusted in height, but ordinary tables do not have this function.
The height of the table cannot be adjusted, and the position cannot be adjusted, so the doctor can only adjust himself.
Kneeling and squatting for surgery, no matter how ridiculous it sounds, it is actually a routine operation for many special surgeries.
"Yuan Zhang, the patient is too heavy. You cannot give too much anesthetic, otherwise the dose will exceed the standard." The anesthesiologist also started to talk about the problem.
"Let's discuss this with the anesthesiology department." Zhang Fan really didn't dare to intervene.
Medicine is divided into several major disciplines. Let’s not talk about the others. Let’s just talk about the anesthesia and clinical disciplines involved in this operation. They are directly different disciplines.
Zhang Fan really didn't dare to give anyone any advice.
"I guess the anesthesia effect is not good because I am too heavy. Zhang Yuan, please try to be as fast as possible when you perform the surgery."
The director of the anesthesiology department was also helpless. It was difficult to control the anesthetic dose for a patient of this size.
Too little medicine will not be effective, and too much medicine may prevent the patient from waking up forever.
"Okay." Zhang Fan agreed, then looked at Xu Xian and Wang Yanan, "Which one of you is raising your feet?"
"Uh!" Xu Xian was so sweaty that he was clearly asking him to lift his feet. Zhang Fan is the leader, Wang Yanan is the girl, he is the only one.
However, looking at the fat boss's legs as thick as elephants, he felt a little bad.
…
"Haha, just lift Xu Xian's leg and I will disinfect it. Don't worry, I'm very fast!"
Although she was wearing a mask, anyone could tell by looking at Wang Yanan's eyes that she was very happy.
Disinfection, surgical disinfection is very strict. It is generally required to disinfect the upper, lower, left and right sides to about 15cm from the incision edge.
Because the patient has a ruptured Achilles tendon, he must lift his lower limbs, starting from the Achilles tendon and continuing to the lower edge of the knee.
And the toe gap is the key point. It is a place where dirt and evil practices are stored. There are abundant sweat glands, and the skin thickens here to form wrinkles in order to resist wear and tear.
This is also the reason why some people’s feet can stink to death even if they don’t have athlete’s foot.
Wang Yanan started disinfecting after washing his hands. Disinfection of lower limb surgery is not troublesome and routine disinfection is enough, but for people who lift their feet, it is too troublesome.
Starting from the connection between the calf and the step, Wang Yanan took the oval forceps and clamped the iodophor cotton ball and began to disinfect it.
At this time, Xu Xian grabbed the patient's instep with both hands and struggled to lift it up because his legs were too thick.
Lifting a few dozen centimeters away from the bed, Xu Xian exerted all his energy in sucking milk. He was grinning under the mask.
At this time, the moment to test Xu Xian's arm strength has come. Whether it is a unicorn arm or not is also reflected.
As Wang Yanan's disinfection scope became smaller and smaller.
Xu Xian started from holding the patient's instep with both hands, and then slowly turned into holding the patient's big toe in his hand.
Not only did he mention it, but Wang Yanan also had to use oval forceps to hold an iodophor cotton ball and wipe it back and forth inside the patient's feet.
This calf weighs at least thirty pounds! Xu Xian held his breath.
Her face and neck were red, one hand was holding the wrist of the other hand, and the thumb and index finger of the other hand were pinching the fleshy big toe tightly.
Fortunately, I have been single for many years, otherwise people who got married early would probably not be able to lift this heavy object.
Xu Xian's heart screamed again, "Ah! Ah! Ah! Come on, come on, shit is about to come out!"
Wang Yanan was very fast and in the end only one big toe was left unsterilized.
As soon as she turned around, she and Zhang Fan turned back to back. Zhang Fan took the small sheet in the surgical bag and quickly spread it on the operating bed.
"Okay, let it go!"
Xu Xian gently put down the patient's feet, and his sweat soaked directly into his hand-washing clothes.
While breathing heavily, he pinched the unicorn finger of his right hand that he usually exercises.
After Wang Yanan finally disinfected his big toes, he took a pair of sterile gloves from the surgical nurse.
"This won't work. It's too small. How big is the largest surgical glove in our hospital?" Wang Yanan asked.
Because the toes are relatively contaminated areas and are too close to the surgical area, they must be wrapped with gloves.
"Eight and a half!"
"Change to size eight and a half."
Surgical gloves are generally size 6 and a half for girls, size 7 for thinner boys, and size 7 and a half, or size 8 for larger hands.
Zhang Fan is 1.8 meters tall and usually wears a size seven and a half. You can imagine how fat the fat boss's feet must be, and the thinner pig's trotters are probably not as heavy as his.
Put on gloves. There are four small sheets on the left, right, and bottom, two middle sheets on the top and bottom, and a hole towel in the middle.
When the sheets were covered, all the fat on the fat boss's body disappeared.
All that was left was a fleshy foot with a rubber cap, standing alone on the green surgical drape.
The fat feet contaminated with iodophor were as fat and greasy as the hilarious bugs in cartoons.
In sports medicine, every Asian country is not doing very well. Bangziguo Medical is a direct copy of the European and American system.
But they took a different approach and led the world's trend in plastic surgery.
Don't underestimate this plastic surgery. Among the authoritative experts in spinal plastic surgery, Bangziguo accounts for the majority. As for facial plastic surgery, they're out of the universe.
Although Maruko Country's medical system does not seem to be very famous, it is the most perfect country that combines Chinese and Western medicine.
Especially in the field of endoscopy, no one in the world can rival us.
As long as we talk about endoscopy, there is no way to bypass Maruko Country. An Olympus endoscope is directly a thing that defies the existence of heaven.
Muscles can be divided into three categories: cardiac muscle, smooth muscle (muscles in internal organs and blood vessel walls), and skeletal muscle.
As for skeletal muscle, there are too many categories. Some are long or short, and have feather-shaped muscles.
The most peculiar thing is the orbicularis muscle. The muscle structure of the lips and anus is similar. Like a wrench made of rubber.
Moreover, there are experts in Chinese medicine who treat hemorrhoids by performing acupuncture directly on the mouth. But strangely, it is effective for hemorrhoids!
Skeletal muscle is like a rubber band attached to two bones.
When the brain gives orders, the skeletal muscles begin to contract and stretch, pulling the connected bones to make various movements.
This is also the only muscle that the brain can command. Myocardium and smooth muscle do not directly control the brain. People have their own systems.
Skeletal movements mobilize a lot of muscles, which are synergistic and antagonistic. Muscles without synergy cannot make fine movements.
Without antagonistic muscles, a simple movement of kicking a football might be enough to bend the knee.
The calf muscles have a muscle belly in the middle and tendons at both ends. One section hangs on the femur and one end hangs on the lower end of the calf.
The stretching depends on the muscle bellies of the skeletal muscles, and the fixation relies on the tendons. The tensile strength of tendons is more than one hundred times that of muscle bellies.
Why have I heard of tendon rupture, but never heard of muscle rupture? Although the tendon is strong, it has no contraction function.
Therefore, when violence occurs, the tendons will sacrifice themselves to absorb a large amount of energy, thereby protecting the bones and muscle bellies.
A rupture of a tendon is considered a rupture as long as there is a slight tear. And according to time, it is divided into acute fracture and chronic fracture.
Many athletes have fallen out with their teams because of this acute or chronic problem.
There is something in this. Tendons can be said to have no blood vessels to supply nutrients. It lives on a thin film covering the surface of the muscle.
Some of the nutrients in the blood are distributed to the membrane, and after the membrane eats and drinks, some is distributed to the tendons. As you age, the membrane transfers fewer nutrients and the tendons become more susceptible to injury.
Acute tendon rupture is called an acute tendon rupture if the surgery is performed within 48 hours, and recovery is relatively easy. Once it exceeds forty-eight hours, it is called a chronic tendon rupture.
Once it exceeds forty-eight hours, no matter surgery or conservative treatment, it is very troublesome, and the effect after recovery is also very poor.
However, after tendon rupture surgery, athletes may not be able to continue to maintain competitive status.
As long as the tendon is not completely ruptured, many teams will give the athlete an analgesic injection and some fixation measures.
In this way, athletes can continue to play. As for the future of the athletes, this is not what they consider.
Therefore, athletes often fall out with their teams due to tendon injuries. Dayao's thumb tendon was treated conservatively for some unknown reason, but...
For tendon repair, the gold standard is open surgical repair. However, plaster fixation and inflatable walking boots are not as effective as open surgery.
Fat people have a lot of fat. Fat is a very strange thing. As long as it is eaten by the human body, whether it is alcohol or nutrition, it must taste it.
The fat boss weighs more than 200 pounds and is covered in fat. If he tastes just a little bit, the amount of medicine he needs is terrifying. The anesthesiologist really didn't dare to give it any more, for fear that the fat man would never wake up again.
After the anesthesia settled down, the fat man quickly fell into sleep. Zhang Fan, Wang Yanan, and Xu Xian also started the operation.
"Alcohol, sharp knife. Hurry up, the amount of anesthetic is not enough." Zhang Fan said quickly while starting to disinfect and operate the knife.
The scalpel cut across the skin, without waiting for Zhang Fan and the others to bluntly separate it. The plump yellow fat particles were quickly squeezed out of the wound like Japanese tofu.
"I'm so fat that the retractor hook is so slippery that I can't hang it!" Wang Yanan struggled to hang it for a long time, but it didn't catch the fat man's skin. There was too much fat and too much oil.
"Electric knife, suction device." Zhang Fan ignored Wang Yanan. As the bleeding was stopped, Zhang Fan used the electric knife to stop the bleeding, and a trace of green smoke started to rise.
There is a saying in surgery: You can judge the quality of a surgeon by the smell of electric paste in the operating room.
The key point of electrosurgery and electrocoagulation is to reach all the points and move quickly and quickly.
When the smell of burning hair comes out, it can be said that the quality of this doctor is extremely poor.
Because he definitely burned the hair follicles in the skin with the electric knife, and it is absolutely forbidden to use the electric knife on the skin.
And smelling a lot of burnt smell indicates that the doctor is of average quality.
It must be that the blood vessels were not clearly seen. Instead of using the point method to stop the bleeding, the electrosurgical knife was placed directly flat to perform electrocoagulation on a large area.
There is only a faint smell of barbecue. For example, the meaty aroma of grilled fat meat when it is cooked but not burnt can arouse appetite.
So this doctor is at least an expert in the use of electrosurgery.
Of course, Zhang Fan's use of the electric knife is definitely at the master level. He has used it countless times in the system.
When he used the electric knife, especially during meal time, you could definitely hear the sound of someone swallowing saliva.
Don't talk about others, sometimes even Zhang Fan himself would be greedy for the green smoke he created.
Highly skilled, right to the point.
To the extreme is art.
…
Of course, if the bleeding is severe, Zhang Fan will not use the electric knife and will just suture it directly.
The incision for tendon repair is very long. Regarding the choice of incision, some doctors believe in small incisions, while others prefer large openings.
Zhang Fan believes in one sentence: Everything should be based on reality and cannot be dogmatic.
The incision heals from one side to the other, not from one end to the other. A suitable incision is the beginning of an operation.
The sharp blade swam in the fatty fat, gently, like a steel boat cutting through the waves on the yellow lake.
Open the skin and cut through the fat. The fat boss's tendons were exposed in front of Zhang Fan.
