godfather of surgery

Chapter 110 Retracting troops in advance
After Xiao Su left.

Dean Pan, officials from the Health Bureau, the township government, and the head of Fang Village all came to see Yang Ping to express their gratitude, sympathy and apology.

Tian Yuan reported Yang Ping's injury to Director Han. Director Han reacted greatly after hearing this, and ordered Tian Yuan to shorten the support time, withdraw troops in advance, and wait for his notice of the specific withdrawal time.

Then the phone call to Yang Ping immediately, anxiously asked about the injury, and told him to rest well.

Soon Director Tian and Song Zimo both received calls, and Director Han urged them to take good care of Yang Ping, so that they must not be infected.

About ten minutes later, Director Han's call came to Tianyuan's mobile phone again.

After answering the phone, Director Tian said: "Go back early in the morning the day after tomorrow, and the hospital will send a car to pick it up. The car will arrive tomorrow. All of us in the orthopedics department will go back early."

"I told Director Han, and Xiao Su also followed." Director Tian added.

Tian Yuan was very busy, and his cell phone rang again. It was from Dean Pan. He received a notification from his superiors that some of the medical team had to go back early because of an emergency at Sanbo Hospital. "

"Going back early? The patient with chronic osteomyelitis of the femur, Xiao Xu, hasn't had the operation yet?" Yang Ping has always been thinking about this patient.

In the bacterial culture of Xiao Xu, coagulase-negative staphylococcus was cultured on the exposed bone, and no bacteria were cultured on the other parts, which was in line with the expected judgment, and the operation could be scheduled.

Director Tian said: "Just leave the operation to Director Zeng, and you should explain clearly the key points of the operation."

Yang Ping was worried: "That won't work. This operation must remove the infected bone tissue very thoroughly. If a little bit is not removed, the operation will fail."

"Then let him come to Sanbo in the future." Director Tian was also in a dilemma, the time for the return trip had been set, and according to Director Han's temper, it was difficult to change it.

"His financial conditions are not good, and now he has no money to go to the provincial capital." Yang Ping sympathized with Xiao Xu.

"Let's do it tomorrow and let Song Zimo take the lead." Yang Ping said.

He asked Xiaowu to call Director Zeng, and told Director Zeng to sterilize the external fixator and supporting equipment in advance, and told the patient to fast from food and water now, and to have a full-length femoral thin-section CT scan tomorrow morning; Vascular color Doppler ultrasound, find the recipient artery at the skin defect site, and the donor site artery at the latissimus dorsi muscle; consult with an internal medicine department for perioperative thyroid function management.

"For this patient, every time the imaging examination, the scope of infected bone tissue has increased. I am afraid that if I don't do it now, the whole femur will be infected by then, and there will be no chance." Yang Ping explained.

"I've seen the patient's film, and I heard that you are considering local bone tissue infection in the femur. Are other imaging abnormalities caused by hyperthyroidism and bone mineral disease?" Director Tian asked.

"Yes, so remove the infected bone tissue as soon as possible." Yang Ping said.

"Tomorrow I will also be on stage to help Song Zimo." Director Tian was very interested.After arranging the surgery, Yang Ping was relieved.

In the evening, Yang Ping went to bed early.

After entering the system, he dissected several experimental subjects, and the anatomical image of the human body was initially established in his mind.

Composition ability is very important for doctors, especially surgeons.

Yang Ping already had a strong ability to compose pictures, and through systematic and powerful training, the anatomical diagram of the human body in his brain gradually became clear.With the eyes closed, the main internal organs, nerves and blood vessels are clearly visible, but some details need to be further enhanced.

In the system, although the physical energy is not consumed, the mental fatigue still exists, so I didn't stay for a long time, I came out of the space and went to sleep.

Early the next morning, Xiao Su came to WeChat and waited outside the dormitory to accompany her to have breakfast.

Looking in the corner, Xiao Su feeds Yang Ping breakfast one bite at a time.

Fatty Liang said: "The first time I saw them, I felt there was a story."

"What story?" Zhang Lin was curious. Is there a story he doesn't know?
The fat man said confidently: "That night, the emergency diagnosis refers to Brother Yang's first operation and Xiao Su as an equipment nurse. The eyes of the two of them were wrong."

"No way? No wonder, we've known each other before. You said that the senior brother came to Sanbo from the People's Hospital because of Xiao Su, right?" Zhang Lin rubbed his chin, made bold guesses, and dug out stories. He has talent.

The fat man nodded affirmatively: "It's probably true. The two of them were secretive before. If it wasn't for Brother Yang's hand injury this time, they would have to hide. How deep is the hiding."

Zhang Lin said: "Yes, this guy. Some time ago, some of us suspected that they were going to get married, but the senior brother was still stubborn and refused to admit it. Now it seems that our guess is right."

Xiao Wu was silent at the side.

"Why are you dumb today?" Zhang Lin asked him.

Xiao Wu is also confused now, and can't figure it out.

After the shift was over, it was not convenient for Yang Ping to make rounds, so Song Zimo led everyone to do rounds.

After the ward rounds, in the doctor's office, everyone was about to discuss Xiao Xu's condition. There was a lot of noise outside, so the director Zeng got up and said, "I'll go out and have a look."

"Here, here!" Teacher Yan came in with a cane.

His son and daughter-in-law carried a large silk banner with a few gold words on it: "Sickness is cured by hand!"

"Director Yang, what's wrong with you?" Teacher Yan exclaimed when he saw Yang Ping's hand.

Yang Ping said with a smile: "It's okay to get scratched accidentally."

Teacher Yan nodded: "That's good, you can't have any problems with your hands."

The old man instructed his son and daughter-in-law to carry the pennant in. This pennant was big enough, at least three times the usual size.

"Director Yang, I have nothing to thank you for. I sent you a pennant to show my heart. I wanted to write a poem, but I couldn't hold it in for two days. It's better to send these words."

After a while of excitement, everyone continued to discuss Xiao Xu's condition, and Director Tian also came to the orthopedics department.

Xiao Xu returned to the ward after finishing the CT scan. The doctor in charge of the bed came up with his CT film, and Director Zeng hung the film on the reading light.

"For this patient, there are three main steps in the surgical procedure. First, remove the intramedullary nail and replace it with an external fixator; second, remove all the diseased bone tissue, and fill the bone defect with calcium sulfate containing vancomycin; third, use The free latissimus dorsi myocutaneous flap repairs the defective part. The most difficult thing is to remove the infected bone tissue. It must be precise and thorough. Every time he has an imaging examination, the range of infected bone tissue is expanding, so we have to re-do it before the operation. Do a thin-section CT scan to determine the extent of the infection."

Yang Ping briefly explained the operation steps, and then read the film carefully in front of the film reading light, saying: "In the straight position, the upper edge of the patella is ten centimeters, and a rectangular bone flap is made, eight centimeters long and three centimeters wide. The midline of the rectangle is this The midline of the segmental femur. Only then can the infected bone tissue be completely removed, and give me a piece of paper."

Someone pulled out a piece of A4 paper from the printer. Yang Ping barely held the pen through the gauze bandage, and began to draw on the paper: "This is the shape of the infected bone tissue, and this is the shape of a cuboid."

Draw an irregular three-dimensional figure on the paper, surrounded by regular cuboids.

"How did you figure it out?" Song Zimo looked at the drawing.

Yang Ping said: "It is constructed based on the graphics of the CT scan, and 20.00% of normal bone tissue is added as a safety zone around it."

Song Zimo thought, this requires a strong ability to compose pictures. If you draw it by yourself, you may have to measure and try again and again before you can draw it. He watched the film like this and drew it by visual inspection. This is how strong the brain composition imaging is. ability.

Director Tian adjusted his glasses: "How sure are you of success?"

"Theoretically, it shouldn't fail." Yang Ping was sure, after all, this range was calculated from the CT scan.

"Trim the skin and muscle defect into an oval shape, 20.00 centimeters long and [-] centimeters wide. The latissimus dorsi myocutaneous flap routinely increases the area by [-]% on this basis. The latissimus dorsi can just repair the defect of the vastus lateralis."

The color ultrasound room came up, and the bed doctor notified.

Yang Ping and the doctors in the ultrasound room searched for the arteries in the defect area and the latissimus dorsi, and marked all available arteries one by one.

A skin flap is to take a piece of skin from one place to fill the missing skin in another place. If the distance is close, the blood vessel can be transferred to the place to fill it. If the distance is far, the blood vessel will be cut off and then connected to the blood vessel in the defect.

Muscle skin flaps are taken together with muscle and skin, which can not only repair the skin, but also repair the muscles.

It's all a kind of job of tearing down the east wall to make up for the west wall.

Yang Ping asked Song Zimo to draw the shape of the defect and the shape of the flap of the latissimus dorsi with a surgical scribe.

"Doctor, when it's done, I'll go to the army."

Xiao Xu still remembers being a soldier.

Yang Ping looked at him wearing glasses: "You are short-sighted, and you are still a soldier?"

Xiao Xu took it off: "Ping mirror, wear it for playing."

I can't be a soldier anymore, the young man will know in the future that sometimes there are contradictions between dreams and reality, and some are irreconcilable contradictions.

The physician looked at the thyroid function data, and it will not affect the operation for the time being. After the operation, the thyroid function will be re-examined and controlled with drugs.

Song Zimo is the chief surgeon, Director Tian is the first assistant, and Director Zeng is the second assistant. This operation is not difficult for Song Zimo.

In the middle, Yang Ping patiently guided Song Zimo on the precise positioning of the infected bone tissue. Song Zimo also has a certain composition ability and is easy to understand.

For the bone tissue that was removed, Yang Ping repeatedly confirmed that the infected bone tissue had been completely removed, and there was a circle of normal bone tissue around it, which was the most ideal situation.

Chronic osteomyelitis is the most troublesome thing in orthopedics, and the most feared thing for orthopedic surgeons.Because the bacteria are hidden in the bone tissue, antibiotics can't reach them, they can't reach them, and they can't help the bacteria. So once you get chronic osteomyelitis, it will come and go, and it won't be cured for many years.

If there were no accidents, Xiao Xu should be able to recover this time.

(End of this chapter)