When doctors have a simulated operating room

Chapter 90



After struggling for a while, Li Cheng said: "How about this, have the family members come? Sign and pay the fee quickly, and we will go directly to the operating table to clean the wound, and decide whether the leg can be reattached while cleaning the wound." Tang Xiaocheng also nodded. This is the only way now. Many fracture surgeries caused by car accidents cannot be 100% confirmed by just looking at the film. Especially for this kind of injury, which is more serious. A large area of ​​debridement must be done and the fractured tissue must be cleaned to see whether the leg can be reattached. There are many conditions for completing replantation. For example, the time of separation of the broken limb should not exceed eight hours. It is best to reattach it within six hours. If this time is exceeded, some blood vessels or tissues of the severed limb will die due to lack of blood.

Then even if it is reattached, it will be useless.

And the preservation of the severed limb is also very important.

It must be placed in the refrigerator at low temperature.

This is to keep it fresh and reduce the chance of necrosis.

The second is blood vessels, nerves, and muscles.

If the bones are in good condition, then it is necessary to check whether the loss of important blood vessels, nerves, and muscles is serious.

The late recovery of the replantation of severed limbs depends on blood vessels, nerves, and muscles.

Otherwise, if the bones are reattached but there are no nerves, the leg will lose sensation.

Without blood vessels, the legs will have no blood circulation and will also die.

Not to mention without muscles, you can't even stand.

Therefore, orthopedic surgery is also a very complicated and time-consuming operation.

It can be as short as five hours.

It can be as long as more than twenty hours.

Twenty minutes later.

The family members of the mother and daughter came.

It was a man under 40 years old.

When he came, he was shaking all over.

There were beads of sweat on his forehead.

After entering the emergency room, he saw that his daughter had lost a leg.

And his wife was lying on the bed with a look of pain on her face.

The man could no longer hold on.

He burst into tears in the emergency room.

He was sobbing and out of breath.

But he knew in his heart.

At this time, the mother and daughter could only rely on him.

He suppressed the grief in his heart, looked at Li Cheng and asked:

"Doctor, how are my wife and children...? Will they be okay?"

"Your wife is out of danger now, there is no other serious trauma, just a closed pneumothorax caused by rib fractures, and the ribs will be reset in the operating room later."

"But your daughter..."

Li Cheng frowned, his face solemn.

The man panted and said carefully:

"Doctor, please help my daughter. She is only nine years old. Please help her connect her legs!

She is still so young. Please help her!"

The man was on the verge of collapse.

The emotions that had just been suppressed came out again.

Li Cheng also understood the feelings of the family members very well.

But for the operation, it is okay if it is okay, and it is not okay if it is not okay.

"I will definitely help, but we have to go into the operating room to know whether the legs can be connected.

You go to apply for hospitalization first and pay 20,000 yuan in the account first.

If this operation can be done, you can make up the money later.

If it can't be done, we will notify you in time."

The man shook his head and grabbed Li Cheng's arm tightly:

"No, doctor, please help my daughter. She is still so young. A girl will definitely be looked down upon if she loses her legs..."

The man wanted a positive answer very much.

But in the hospital, no one could give him a definite answer.

Alas!

Everyone sighed.

If the injury was a little lighter.

If it was not severed, Li Cheng might have a better chance.

But now.

According to his observation, the girl's right calf was first crushed and then twisted.

The broken bone fragments are probably not recoverable.

So this operation is really difficult.

"I will do my best, don't worry, I will do my best."

Li Cheng could only say this.

Looking at the man's red eyes, Li Cheng turned around and began to prepare for the operation.

Pay the fee and go through the hospital admission.

Twenty minutes later, the mother and daughter were pushed into the operating room one by one.

Debridement requires manpower, and Li Cheng also specially asked Tang Xiaocheng to help.

In the operating room, separated by a wall.

On one side is the mother's rib surgery.

On the other side is the daughter's limb replantation surgery.

Outside the operating room, the man sat with lifeless eyes.

On the bench in the corridor.

He clasped his hands together and kept muttering something:

"God... please protect the mother and daughter.

Please, I can exchange everything I have, but you must protect Xinxin's leg so that it can be reattached..."

In the operating room.

Huang Yuanxin had been fully anesthetized and was sleeping peacefully.

The proximal end of her right calf was being repeatedly washed with saline by Li Cheng and Tang Xiaocheng.

The distal end was taken to another operating table for cleaning by two other doctors in the orthopedic surgery department.

In addition to saline.

A large amount of disinfectant, sterile soapy water and tissue brushes are also needed to repeatedly scrub the cross section.

All dirt and foreign matter on the cross section must be rinsed clean.

Otherwise, it is easy to cause postoperative infection.

The dried blood was washed, and after changing the water several times, the cross section tissue was brushed from dark red to a light flesh pink.

Next, start to check each nerve and blood vessel.

If you find that there is necrosis, don't hesitate, just cut it off.

Because once the necrotic tissue is not removed, after the replantation is successful, a small necrosis will trigger a series of reactions throughout the body.

Therefore, the necrotic tissue must be removed, and only the relatively intact parts that are not contaminated are retained.

Trimming is also included in the scope of debridement.

If suturing is the basic skill of surgical operation.

Then debridement is the basic skill of orthopedic surgery.

Trim the uneven cross-section neatly.

When trimming, pay attention to the length of the blood vessels at both ends.

Gradually, the more he trimmed, the deeper the wrinkles between Li Cheng's eyebrows became.

Suddenly, Li Cheng's hand paused.

He found a very serious problem!

Tang Xiaocheng looked at him: "What's wrong, Director Li?"

"The lateral sural cutaneous nerve is missing here! And here, the small saphenous vein is not found, and the popliteal artery is not found here.

Xiao He, how long is your trimming? Did you see the small saphenous vein and popliteal artery?"

If one end is missing, then you can only count on the other end.

But the doctor named Xiao He shook his head.

"Master, I... I can't find it."

Li Cheng sighed and said, "I'll look for it."

After checking for more than 20 minutes, Li Cheng still couldn't find it.

"It's bad, a large part of the popliteal artery and the small saphenous vein are missing, and the lateral sural cutaneous nerve is not seen."

Looking at the tibia and fibula that were broken into more than ten pieces.

Li Cheng could only sigh helplessly:

"Forget it, after cleaning the wound, it was found that there were too many injuries. This leg can't be connected at all. Tell the family to amputate to save his life."


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