Doctor’s Life Simulator

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Wei Guoqiang has been going back and forth between Modu and Hangcheng to handle various matters in the treatment center these days. It is a lie to say that he is not tired.

Until he saw these photos, he suddenly felt that it was all worth it.

The ability to treat and control such a rare, acute and explosive Fornier's gangrene so well is a testament to the strength of the treatment center.

In a few days, it will be the regular meeting of the hospital, and it will also be the start-up meeting for the application of the wound treatment center.

In addition to various external conditions, various relationships of the Society, Zijingang No. 1 Hospital, and the full support of Huashan Hospital Affiliated to Aurora University, what Wei Guoqiang needs most now is this kind of treatment that can explain how the treatment center can deal with various diseases. , a case of the ability to treat the situation.

"Even in the early treatment of the rare Fornier's gangrene at the First Affiliated Hospital of Zijingang University, it is at this level."

Wei Guoqiang was very happy and proud of his team of junior doctors.

"Dr. Wu, tell our plan consultation team and surgical team, I, Wei Guoqiang, wish you a successful operation in Hangzhou. For this rare Fornier gangrene, our treatment center's response and treatment are better than I imagined. ."

"Your case today also reminded me. This hospital meeting is about to start. We also just collected the typical cases of admission, consultation and operation in the past few days. I am going to have a regular meeting in the hospital. Give a brief presentation on the features and capabilities of our treatment center.”

After Wei Guoqiang sent the message, he was ready to return to the First City Hospital in a good mood.

...

...

In the operating room of a city hospital.

Qin Lang marked the patient's eagle internal artery flap with methylene blue, located in the ischiorectal fossa between the steel door, the eagle's nest, and the ischial tubercle.

"...handheld Doppler, scalpel..."

Qin Lang gave the order again. I have to say that the equipment list compiled by Tian Bo is really cutting-edge and advanced, and played a crucial role in this operation.

Qin Lang controlled the hand-held Doppler to determine the location of the perforating vessels of the eagle internal artery, and measured the area of ​​the defect.

Soon, Qin Lang completed the design of the skin flap. The area of ​​the entire skin flap was 12cmX8cm, and the ulceration area of ​​the patient was huge.

Looking at Qin Lang's flap design and incision, Wu Youtu and You Daren felt a sense of envy again.

"Sure enough, geniuses and mortals are different."

Wu Youtu has an idea now. Before Qin Lang grows up, he will try his best to shield him from the wind and rain and give him a smooth growth environment.

On the operating table, Qin Lang had already made an incision on the upper edge of the flap, precisely controlling the deep fascia contained in the flap, while the epimysium remained on the bottom.

After that, there is a perfect degree of separation until the previously marked perforator point is reached, which originates at the intermuscular septum between the adductor longus and gracilis.

"What a powerful technique, it's really pleasing to the eye."

Looking at Qin Lang's unusual skin flap separation technique, You Daren was very excited. Isn't this the ultimate micro-manipulation skill that he has been longing for.

"This Qin Lang is really, for this wound treatment center in our department, it's here!"

Wu Youtu and You Daren were already convinced that as long as Qin Lang stayed at the wound center for one day, it would be the Dinghaishenzhen in the field of flap repair, debridement and suture.

"As long as this operation is successfully completed in the end, it will definitely become a classic case. It will also be the most splendid demonstration of medical capabilities since the opening of my treatment center."

Wu Youtu has a great view of the overall situation. At this stage, he has already begun to figure out how to use Qin Lang's operation to increase the popularity and influence of the treatment center.

And Qin Lang in the operation center was still carefully separating the flap, and made an incision on the lower edge of the flap.

The gracilis muscle was found here, and the flap still contained the deep fascia, which was dissected up and advanced to the intermuscular septum.

The intermuscular septum is incised distally to proximally up to the perforator, and the flap is fully rotated.

"...3/0 Absorbable Thread, Needle Holder, Electric Hemostatic Knife..."

Qin Lang started the next operation non-stop, and soon completed the suture of the flap.

"...2 drainage tubes, one is placed under the cake pill to drain the hawk's nest area, and the second is placed under the donor area..."

Under Qin Lang's orders, You Daren, the first assistant, obeyed orders, and completed the operation An'an.

Soon, under the leadership of Qin Lang, a closed supply area was completed.

The suprapubic local skin flap is a rotating skin flap, and the skin defect is 3cmX4cm, but there is a 12cmX8cm sneak area subcutaneously to the inguinal head and cephalic direction. Therefore, Qin Lang designed a very special bilateral partial rotating skin flap with an area of ​​about 6cmX8cm and 8cmX8cm.

Seeing You Daren was a little puzzled, Qin Lang added:

"This approach, while covering the defect, can eliminate the dead space."

You Daren seems to understand, but he plans to wait for the operation to finish before going back and forth to study the video of the operation.

"...4/0 non-absorbable thread..."

Qin Lang then completed the final skin stitching. At this point, the entire operation was completed perfectly.

Until this moment, everyone was completely relaxed, and the patient's various signs also showed that the operation was fruitful.

"Dr. Wu, the next step is to pay attention to the adjustment of the patient's systemic state, improve immunity and systemic supportive treatment. In particular, for the anemia and hypoproteinemia caused by the consumption of the patient's systemic infection, it needs to be actively corrected. The next 12 hours , always be vigilant, and use broad-spectrum antimicrobials.”

Wu Youtu naturally took the order with pleasure: "Qin Lang, it's hard work, the next thing will be left to us."

After all, it is a team. Qin Lang has already performed such continuous operations. Of course, they will not lose the chain in the follow-up follow-up.

"Qin Lang, how did you diagnose Fornier's gangrene and successfully implement such an effective treatment plan?"

After all, You Daren still asked the puzzlement in his heart.

Wu Youtu also pricked up his ears. He also wanted to know how Qin Lang turned the tide and solved the biggest difficulty since the treatment center opened.

Qin Lang shrugged and said a little embarrassedly:

"Everyone knows that our community hospital is very busy. We either dispense medicines for aunts or measure blood pressure for uncles. Therefore, when we have nothing to do, we will look through the latest medical impurities and international journals."

"On the bookshelf in the office, Dr. Zhou regularly buys all kinds of journal impurities, and I will take them to see if I have nothing to do. Then, the two of us just chat casually. Just last time, I went to Zijingang No. Deputy Director Shen and Professor Qian talked about the case of Fornier's gangrene."

Qin Lang continued to say half-truth:

"At that time, Deputy Director Shen proposed that the main treatment principles for Fornier's gangrene are: adjustment of systemic state, including active fluid resuscitation and application of broad-spectrum antibiotics; rapid debridement of necrotic tissue; postoperative local negative pressure treatment of wounds Close repair."

"Of course, regarding the connection and integration of negative pressure suction therapy, I would like to thank Director Tian Bo for his equipment purchase list. This latest equipment can play a key role."

You Daren and Wu Youtu, of course, had never practiced it before, so they asked, "What's the explanation?"

Seeing that the two of them were successfully changed the topic by himself, Qin Lang said in a vehement manner:

"Principles of wound negative pressure suction therapy: First, it can cause changes in the microenvironment of the wound through mechanical-biological effects, thereby promoting the growth of granulation tissue and accelerating wound healing."

"Second, to reduce tissue edema in the wound and eliminate dead space."

"Third, close the negative pressure environment to prevent bacterial invasion and prevent cross infection."

"Fourth, mechanical stress induced by negative pressure can promote cell proliferation and tissue repair."

"Fifth, reduce post-traumatic immunosuppression and cell apoptosis, promote repair cell proliferation, and the formation of microvessels. To sum up, I think this can be a brand-new auxiliary method and idea for the treatment of Fornier's gangrene!"

As he spoke, Qin Lang's eyes lit up.

Wu Youtu and You Daren were also applauded by the festival. Their wound treatment center is currently lacking only the power of doctors, but it is not a research topic!

"Qin Lang, I think we've done a great job by accident!"

PS: Thanks to book friends 2022026150807969 for the 500 coins reward~