Surgical skills and talent are one aspect, but they also require a lot of practice. In the past few decades, the medical system emphasized technology rather than skills.
There was a joke at the beginning that the experts in tertiary hospitals could not treat colds. It sounded funny, but it was actually true. Then the country felt that if this situation continued, the overall medical education level would catch up with the national level, but the medical level was getting worse and worse. .
This is how the regulated training system came into being, which has its advantages and disadvantages.
To put it simply, medical qualifications are actually technology, and practical application is skills. In this regard, Tea Su has suffered a big loss. After Chasu Hospital had just started to improve, Zhang Fan and Ouyang went south to recruit.
We recruited many doctors and masters with excellent academic qualifications and excellent academic performance, but within two years, they did not perform as well as they did in the hospital.
On the one hand, it is related to the fact that tea is a primary hospital, and on the other hand, it is closely related to medical education.
The original group of people could read, take exams, write papers, and do experiments, but they just couldn't see a doctor. Internal medicine is a little better, but surgery, one counts each, and there are two or three doctors who have not yet obtained basic surgery.
Fortunately, Tea Sue has the International Medical University, otherwise these doctors would be called non-performing assets.
For example, Li Cunhou's team originally said that they were participants in the invention and should be better than others in the application of materials for allogeneic transplantation. But what is unexpected is that this group of people includes Li Cunhou. Once the difficulty of the operation increases, they will sit on the wax.
As for moderation, it can almost be said to be the ceiling of Chinese medical care.
Surgeon-in-Chief: Zhang Fan. When Zhang Fan performed surgery in the past, it was very embarrassing when filling in the surgical records.
Before anesthesia is administered and before the surgical package is opened, the circulating nurse must once again confirm the list of surgeons. Even if they know it in their heart, they still have to ask in the operating room.
This is one of the supervisory powers of the traveling nurse. In the past, when I went to other places to do knife surgery, and I met a smarter nurse, they would say, "Zhang Fan, the surgeon, is the doctor."
Although this statement is wrong, it sounds better after all, because in the operating room, this kind of confirmation does not refer to administrative positions, but to professional titles.
For example, director refers to a senior doctor, not the director in charge of the department.
There are also honest people who directly call out the chief resident doctor Zhang Fan.
Not only was Zhang Fan embarrassed, the director who invited Zhang Fan to fly the knife was also embarrassed.
It's better now. It's not as embarrassing as before. Dr. Zhang Fan, the surgeon, sounds very grand.
The first assistant is academician Li Cunhou, and the second assistant is deputy chief physician Ma Yusheng of the Department of Dermatology.
In fact, when he got to the operating table, Li Cunhou's assistant was replaced by Director Ma. Li Cunhou was on the instrument nurse's instrument table helping to prepare the consumables for allograft transplantation.
When working with Li Cunhou, Zhang Fan felt like he was working with someone who was slow. He obviously went in and waited for the other party to respond, but when he didn't, when he continued to the next step, this guy screamed out, which made Zhang Fan nervous as he was preparing for the second step.
He only realized it at this time and went in.
Fortunately, Zhang Fan got used to it after working with Li Cunhou a lot.
But working with Director Ma was different. From the moment Zhang Fan held the knife, it felt different.
How to describe this, it's like a muscular man facing a muscular woman, back and forth, and it can also give the other person a sense of urgency.
It feels like a muscular woman is always tightening her muscles to come up.
There was no need to speak for incision, pulling, and hemostasis, and there was no need for Zhang Fan to hold the tweezers to give prompts.
Every step of the movement was perfectly coordinated. Where Zhang Fan's knife was, his suction device was there. Where Zhang Fan's scissors were, his tweezers were there.
Moreover, after all, it is Director Ma who is the surgeon at an old age. On the operating table, he is better able to understand how to pose to make Zhang Fan more comfortable. This is definitely not about driving, but a serious fact.
This is why before going to the operating table, a surgeon must first identify an assistant. As for other assistants, they only need to be able to be obedient.
This surgery was very difficult, but Zhang Fan did it very comfortably. Because Director Ma Ma Yusheng has high feeding skills.
Neither of them spoke, or even made eye contact, just hand-to-hand contact.
The surgery became more comfortable and faster, and Zhang Fan became more and more satisfied.
Compared with Ma Yusheng's surgery, Li Cunhou's surgery was just like a middle-aged man's task, and he had to grit his teeth.
"A three centimeter wedge!"
Zhang Fan said softly and without raising his head, Li Cunhou looked at the progress of the operation on the operating table and immediately made a wedge-shaped skin graft of about three centimeters.
This person is not good at surgery, but he is good at making materials. For example, the material near the child's chin needs to have a certain curvature, and he does it very well. It is neither too big nor too small. When he lifts it up, it looks like it was originally that way.
To be honest, Lao Li really ruined this pair of vicious eyes by not becoming an equipment dealer.
After the hemangioma is completely removed, the difficulty of the operation arises.
Although the child's face is small, the corresponding facial transplant area is larger. First, point-like vascular flaps distributed under the transplanted skin must be established.
How to describe it, this thing is like a small nest on a potato, and this small nest is used for germination.
This is the function of the vascular valve. After the vascular valve is made and then covered with the allogeneic skin, countless vascular networks will be slowly derived like a spider web based on the vascular valve, and these vascular networks can provide nutrients to the allogeneic skin.
The allogeneic skin will survive and then be slowly absorbed. In the end, there will be almost no difference in the face. This is why Lao Li can become an academician.
Little by little, four hands, four different incisions, are constantly crossing each other and intersecting with each other.
The movements between the tweezers and pliers at this time were like a pair of young lovers feeding each other mouth-to-mouth, which is not an exaggeration at all.
Little by little, gently cover the baby's face, just like a girl's facial mask before going to bed, gently cover it.
Then use moist gauze dipped in physiological saline, gently push it slowly with your fingers, and apply it bit by bit. At this time, you must not leave any excess or bulging areas.
This kind of small bulge doesn't seem to matter now. Once it is sutured and the child becomes normal again, with luck, maybe this place is a dimple.
But once you are unlucky, this place will be like a disease of flowers and willows, and a flesh will grow out.
The doctor didn't dare to gamble, and couldn't gamble. He wrapped his fingers in wet gauze and pushed little by little.
Finally, the hardest part comes, the stitching.
In other surgeries, during the suturing period, it means that the operation is almost finished, but this is not the case in dermatology. In dermatology, the final suturing is often the most difficult part.
If the suturing is not good, the simplest thing is that the recovery and healing is not good. People who have had surgery may have experienced the incision not healing.
This kind of suture is very troublesome if it doesn't heal with just a few stitches.
It was as if there was an extra child's mouth on her belly. Not only was it bleeding with pus and water every day, but she also had to endure the torture of changing dressings every day.
There is a fear that this kind of facial suture will not heal, and even more, there will be a large number of thick scars after healing.
Almost all surgeries do not mention suturing. Only dermatology surgeries emphasize fine suturing.
What is fine stitching.
Zhang Fan sutured with a microscope.
Zhang Fan and Ma Yusheng were like pirates, each with a microscope on each eye. The small round needle was much smaller than the embroidery needle, and all the surgical instruments were extremely small.
Two pairs of big hands were placed on the child's face, leaving only a small gap in the operating space.
In this gap, two people performed unimaginable movements.
Pushing forward bit by bit, the child's jaw began to move, Zhang Fan probed his head, and Ma Yusheng could only kneel down.
The position of a child is too difficult to manipulate. Zhang Fan was a little ahead and Ma Yusheng could only move back. But his jaw was so big, not much bigger than a small cake. In this position, Ma Yusheng could only kneel half-kneeling and raise his head to operate from the side. .
It was uncomfortable for Zhang Fan to stretch his neck and half-bend, and it was even more uncomfortable for Ma Yusheng to kneel down and raise his head.
However, we can only persist like this, gritting our teeth and persisting.
He could only hope that Zhang Fan could move faster, but he couldn't push him too hard. The harder he pushed, the slower he would go, and then he would go soft.
The suturing of the mandible makes the doctor uncomfortable, so the suturing of the nasal cavity and eye socket directly makes the doctor collapse.
Especially for the suturing of the parts inside and outside the nasal cavity, which was originally a small hole, now two instruments have to be inserted to sew it, and a knot must be tied inside.
In this operation, every time the knot was tied, the two of them shut up and held their breath, waiting for the two pairs of big eyes, just like a pair of male and female toads staring at each other.
Little by little, the surgical sutures were done slowly, but time passed quickly.
Outside the operating room, the child's parents gradually became listless from being irritable at the beginning, and finally just lost their strength.
The two of them didn't even have the strength to look at each other.
People are waiting like this, and the doctors in the operating room are even more exhausted.
The circulating nurses have changed twice.
Finally, after the last stitch between the eyebrows was cut, the surgery on the child's face was finally completed.
Due to long-term facial operations, the child's originally fleshy face has now become as round as a silver plate.
Especially the sutures on both sides were swollen, as if the little head had been put into a balloon filled with water.
However, the suturing done during the operation was really good. Apart from a faint circle of red scars, there was almost no stitching visible.
"It's really good. When covered with this material, it's just like the original skin!" Lao Li said as if he was boasting.
"What a pity!" Zhang Fan let out a long sigh.
After the operation was completed, not only the doctor was happy, but also the anesthesia and nurses in the operating room felt happy and even accomplished.
Everyone came over to look at the baby. The originally scary burgundy color was gone. Although the face was swollen like a big egg, it no longer made people feel scared at this time.
But Zhang Fan let out a long sigh, which made everyone feel so nervous.
Didn't the surgery go well?
Ma Yusheng's expression turned extremely ugly! (To be continued)
