He whispered in a low voice: "You have let down a girl like this before, no wonder I call you a scumbag."

Wu Xie gritted his teeth and didn't reply.

Luo Wei continued to ask Long Yuan for advice. After learning the truth of the matter, he looked at Wu Xie: "That's a little bit scumbag."

Very tactful.

Wu Xie continued to remain expressionless.

Because there is surgery, the ward rounds will be a little faster.

It was only in front of the old man with the big swelling yesterday that he stopped.

Lu Junyin, who has always been very cautious, his eyes flickered at this moment, and he told Zhong Yusheng, who was on duty today: "Yusheng, this old man, the preoperative examination must be in place, especially the heart function and past medical history."

"Then, given your father's situation, you need to arrange a car to send the sliced ​​specimens to the county hospital. Our hospital rarely performs such operations, and our hospital does not have a pathology department."

Lu Junyin's words were very reserved, almost as if he wanted to drive the patient away.

In Lu Junyin's view, there is no need to worry about such diseases in the department. Performing such operations is thankless.

Such a big tumor, and it was also said to be an intussusception cyst, with a high recurrence rate. If it was not dealt with properly, it would be a medical dispute. I couldn't bear it, so Longyuan took it in.

Long Yuan is a master of art and bold.

But if he can persuade the family members or the patient himself to quit, then it’s not that he doesn’t want to perform surgery on Long Yuan, it’s the patient’s own choice.

"Director Lu, okay, Doctor Long has told me about this matter before. Don't worry, I can arrange it myself." She came here for Long Yuan, and she would definitely not leave so easily.

Long Yuan knew what Lu Junyin meant, but he didn't reveal it. He just said: "Sister, don't take it too seriously. Your father's situation is indeed quite complicated. We also want to consider it carefully, just in case.

"

The woman continued to nod after hearing this: "I know Dr. Long, thank you."

Then he looked at Lu Junyin, and clearly regarded Lu Junyin as a bastard who was not very capable and didn't want to take responsibility.

However, Lu Junyin has Lu Junyin's concerns and considerations. He is the director of surgery. Even if something goes wrong with Long Yuan during the operation, he will still be responsible.

After explaining the detailed preoperative examination, Long Yuan led the team to the operating room.

Then I saw Chen Chen, Fan Qingqing and other operating room nurses in the operating room being extremely cautious, looking at Chu Yuming on the operating table and avoiding him.

Naturally, I am afraid. Syphilis is blood-borne contagion. If I am not careful, it will be difficult to explain to those who have a family when they return home. As for Fan Qingqing, who is not married, there may be misunderstandings when looking for a partner in the future.

After being infected, even if the antigen is negative, the antibody is still positive.

Antibodies mean that you have been infected and will never be able to get rid of them for the rest of your life.

However, the nurse in the operating room does not have the right to arrange the operation. In large hospitals, the operating room may be a separate department. They may have the right to refuse surgery, but they cannot refuse treatment because the patient has syphilis.

Maybe he knew that, so Long Yuan took the initiative to propose: "Director Lu, let me handle this surgery. Everyone wears two pairs of gloves. Joint surgery must be double-gloved."

"Sister Chen, please prepare a few extra pairs of gloves. We may need to replace them multiple times during the operation."

When Chen Chen heard this, he felt a little embarrassed, but for his own sake, he still did not take the initiative to suggest that he should continue to be a device nurse.

Disinfection and draping are all basic skills.

And because Long Yuan went to the stage to serve as an instrument technician, Guo Lixiang also joined the stage.

Wu Xie stood at the surgeon's position, holding a lancet before starting, and said to the circulating nurse and anesthesiologist in the operating room: "Right knee arthrotomy + right knee joint infection debridement, start now, the operation starts at eight

Point forty-one.”

Wu Xie's tone was clear and concise. After informing him of the method and start time of the operation, he started to make incisions...

The circulating nurse hurriedly registered it on the operation sheet, and the three of them started to coordinate the operation intensively at the same time, such as installing the negative pressure suction device of the suction device, preparing the electrocoagulation knife, and what new instruments and silk threads might be needed.

Tie knots etc...

Under the operating table and in front of the anesthesia machine, Dong Chun and Tan Hong were talking and secretly glanced at Tang Yuewei.

Tang Yuewei has an exquisite figure, and the washcloth and warm backsuit still cannot hide her graceful figure. However, at this moment, Tang Yuewei's eyes are quite blurred, as if she is fine, and she has not seen her for a long time.

a feeling of.

If such a look appeared on a middle-aged person, it would naturally not be a big deal, but if it appeared on the still very young Tang Yuewei, it would look a little bit out of place.

However, at this moment, the person who truly understood Tang Yuewei was Long Yuan.

Because both Long Yuan and Tang Yuewei had seen Wu Xie's charm and confidence at his peak.

In the first year of my master's degree, I have already started to perform surgeries and have started to train doctors. I am very outstanding among graduate students at the same level and even in front of my fellow master's students. Not to mention riding alone, it can be said that I have gone a little further.

.

At that time, Wu Xie was also so confident, mature and steady. He would start the operation as soon as he was told. He had solid basic skills and clearly grasped every step of the operation and arranged it clearly.

More than two years have passed since they remembered this scene.

Long Yuan did not participate, mainly because he wanted to observe Wu Xie's current basic surgical skills.

This is an arthrotomy + joint debridement.

The treatment principles for intra-articular infection are: sensitive antibiotics, thorough debridement, joint drainage, analgesia, anti-inflammation, and postoperative joint fixation. This is the overall treatment concept.

Among them, thorough debridement and joint drainage are the focus and core of the entire surgery.

Only after you understand what the core is, can you look at Wu Xie's operations.

In Long Yuan's field of vision, it can be seen that Wu Xie's basic skills have recovered somewhat, although it is not as good as the peak period. At the peak period, Wu Xie could enter the joint cavity within two minutes with almost no bleeding.

, able to control every operation of the knife just right according to the anatomical level.

But it is already very solid and has a systematic understanding of incision surgery.

The knife goes under the skin without cutting into the fascial layer, ensuring that the blood vessels are damaged during the cutting process of the lancet knife and increasing blood flow.

Then use electrocoagulation to slowly stop the bleeding to the muscle layer, and bluntly break the muscle layer to the joint capsule layer.

After reaching the joint capsule layer, bluntly puncture the joint capsule again, open a very small opening, and use a negative pressure suction device to suck out a large amount of pus in the joint cavity to avoid contamination of the external open wound.

The overall thinking is very clear and hearty, the surgical process is efficient, and the surgical field is extremely refreshing.

This exposure process demonstrates very solid basic skills and understanding of joint infection. Unfortunately, no one can appreciate it at present. In the eyes of Lu Junyin and others, this may be a routine operation.

Fortunately, he came. Otherwise, Wu Xie would have followed people like Lu Junyin. Even if he followed people from the county hospital represented by Luo Wei, it might be true that although I am invincible, no one can understand me.

It’s hard to find a confidant, let alone study?

Then continue reading——

After Wu Xie aspirated out a large number of abscesses in the joint cavity, he did not rush to open the joint cavity. Instead, he first completely separated the existing incision, then chose to incise the knee joint capsule and perform debridement carefully.

.

Joint cavity infection, joint effusion and various cavities must be cleaned out.

Moreover, due to the presence of infection, the joints inside are closed, contaminated with a large amount of pus, and there are also gum swellings caused by syphilis.

Debridement is an important subsequent operation.

In fact, many people can do debridement, and it is also a basic skill of surgery. However, the skill of debridement operation depends on whether the level of debridement is just right.

This is just like, if you have onychomycosis on your toes, if you simply amputate your toes, is it considered a cure?

Of course, if you don’t have toenails, how can you still have onychomycosis? It’s just that you’re missing a toe.

Of course, this is an analogy, and the lack of toes and the incomplete function are obvious at a glance.

In fact, debridement in the body is also similar, but the degree of manifestation is different.

Moreover, although Long Yuan does not know much about joint infections, which are classified under the Department of Joint Surgery at Tongji Hospital, he knows that there are many details that need to be controlled during the debridement process, and there are many points that need to be paid attention to on the joint surface.

.

For example, the femoral and tibial plateaus are cartilage surfaces.

Whether you want to remove all the cartilage surface during debridement is an option, and partial removal is also an option. If the cartilage surface is injured, it will definitely easily induce osteoarthritis later on.

One of the biggest manifestations of osteoarthritis of the knee joint is damage to the cartilage surface.

Naturally, there are also many attachment surfaces such as the anterior cruciate ligament and meniscus, as well as the issue of how to deal with the gaps between these ligaments and the meniscus.

Long Yuan was watching, and he planned to give some advice at the right time, instead of just being a hands-off shopkeeper, just to evaluate Wu Xie's abilities and just give up!

However, during Wu Xie's debridement process, he discovered that Wu Xie's debridement method was a micro-surface scraping, and even some necrotic tissue was not completely removed.

It looks like an absolute novice who is reluctant to remove necrotic tissue.

When Wu Xie had progressed for twenty minutes, Long Yuan coughed and moved closer to the operating table: "The debridement must be more thorough, otherwise, infection will easily continue in the future. There will be residual infection lesions."

The main purpose of thorough debridement is to be thorough and not to leave any infection foci.

The reproductive capacity of bacteria is beyond your imagination. If you leave a little bit behind in one night, it will develop to the point where you will doubt your life and the entire operation will be in vain. This is not alarmist.

No one asked, so Wu Xie didn't explain on his own initiative.

However, since his senior brother asked, Wu Xie still had to explain a few words.

"Brother, the main blood supply sources of knee joint cartilage include: periarticular blood vessels and synovial blood supply, including the blood supply distribution of the meniscus, which is also in a similar form."

"The difficulty in treating intra-articular infection is that there are hidden cavities with very little blood supply, so it is difficult to reach them through intravenous injection of antibiotics and flushing of intra-articular antibiotics. Therefore, this is the theoretical principle of complete debridement of joint infection.
To be continued...