The road to the rise of great doctors

Chapter 37 "Youth" at night

"Where is the patient's injury?" Liu Dong followed closely behind the young nurse and asked as he walked.

Surgical suturing operations are basically clean and neat incisions.The wounds in the emergency department may be dirty or crooked, just like a child's simple drawing, which is elusive.

For such a strange wound, the suturing operation may not be too difficult, but it is difficult to make it look good without being thick and earthworm-shaped after healing.

And if you want to achieve the level of seeing that you can see it after healing, it will test the surgeon's design and intention.You must know that the thickness of the suture and whether the patient has scars are all important factors that affect healing.

Liu Dong was both nervous and excited.

"After I fell while riding an electric scooter, my hand hit a wire and made several cuts of varying sizes." The young nurse replied calmly, which was not surprising to her.

She said as she walked, and quickly led Liu Dong to the emergency room.

When the two walked into the treatment room, they saw a man in his 30s lying on the operating bed. The outstretched arm of the operating bed was covered with a waterproof towel. There was a yellow trash can for medical waste on one side of the bed.

Not far from the trash can, there is a dressing cart. There is an unopened suture kit, 1 bottle of hydrogen peroxide, 1 bottle of iodophor disinfectant and 2 bottles of physiological saline.

At this moment, Dr. Zhou was wearing a mask, a hat and disposable gloves, with his back to himself. He took off the injured man's messily wrapped tissues and threw them into the trash can. After the wound was exposed, he was checking the condition of the wound.

The blood is still flowing, but not much anymore.Dr. Zhou said: "There should be no arterial bleeding, which is a blessing among misfortunes."

Liu Dong also looked at the wound and let out a breath of relief.

"Dr. Zhou, Dr. Liu is here." The little nurse said in a clear voice.

"Thank you." Dr. Zhou paused for a moment, looked back at Liu Dong, and recognized the intern who had just given him a bottle of drink and who had come to consult on urological diseases before.

The Affiliated Hospital of Medical College is the largest comprehensive tertiary hospital in the province with many employees. As a teaching hospital, there are also many visiting doctors, postgraduate doctors, intern doctors and trainee doctors.Only those who are familiar with it or big experts will know it.Others just looked familiar.

At this time, the patient was lying on the bed and conscious. Dr. Zhou didn't ask any questions, so he nodded and said, "Dr. Liu, make sterile preparations and come over to help."

Liu Dong responded and took a hat and a pair of disposable gloves from the cabinet next to him.When he came over, he had already put on a mask.

Because this patient's wound is not clean, it should require debridement and suturing.But he had learned these contents in surgery class before, but when it came to practical operation, it was the "first time" for a big girl to get on a sedan chair.

After these three weeks of internship in urology surgery, he first learned a truth, that is, at work, don’t do anything blindly when you don’t understand, follow the instructions first, and the high-ranking doctor on site is the “commander”.

After Liu Dong was ready, he said to Dr. Zhou without any extra movement: "Doctor Zhou, what do you think I need to do?"

After hearing this, Dr. Zhou understood the current situation, and he still liked this move very much.He looked at the patient. The patient was awake, but in pain and scared. His eyes were closed and he looked very nervous.

As an old man in the emergency department, Dr. Zhou is familiar with the principle of "doing well, but also speaking well", and is full of "care" for this kind of patients.

I saw him saying to the patient before the operation: "Now let's start debridement. People like you who are injured externally need to be rinsed before suturing, otherwise they are prone to infection, and the incision will not grow well after infection. What about this process? There will be some pain, please bear with it first.”

Then he said to Liu Dong: "The first step in our debridement here is to rinse several times with hydrogen peroxide and saline to clean the dirt around the wound and the dirt in the wound. Then, disinfect. "

With that said, Dr. Zhou began to demonstrate, asking the patient to put his hands on top of the medical waste trash can, and then rinse with hydrogen peroxide and saline alternately three times. "This kind of hydrogen peroxide may sometimes be replaced by soap or other decontamination liquids in other hospitals."

After rinsing, he said to Liu Dong: "Xiao Liu, put another sterile towel on the operating bed."

After Liu Dong's surgery, Dr. Zhou asked the patient to place the injured hand on top of the sterile towel with the wound facing upward.

Seeing this, Liu Dong understood that the debridement had been completed, and preparations for disinfection, draping, inspection, and suturing would follow.This is just like regular surgery.I saw him open the suture bag on the dressing changing cart, open the needle and thread, 2 packs of sterile gauze, and a syringe, and pour them into the suture bag.

At this time, Dr. Zhou also changed his sterile gloves, picked up the dressing bowl in the suture bag, and Liu Dong picked up the disinfectant and poured it in.

When Dr. Zhou was disinfecting, Liu Dong took the initiative to open the lidocaine and normal saline, then put on sterile gloves, picked up the syringe, diluted the lidocaine 1:1 and sucked it into the syringe.

After waiting for Dr. Zhou to disinfect and spread the drape, Liu Dong immediately handed over the prepared syringe containing local anesthetic to Dr. Zhou.

After Dr. Zhou received it, he glanced at the syringe and Liu Dong, and injected it into the edge of the patient's wound.

Liu Dong carefully observed Dr. Zhou's technique. After the blood was withdrawn first and there was no blood reflux, local anesthesia was gradually applied. After one round, there was still some local anesthetic left.In Dr. Zhou’s words, “If any area hurts badly during the operation, you can re-inject it.”

After waiting for a while, Dr. Zhou used tweezers to pinch the skin around the patient's wound. After checking that the patient had no reaction and verbally said "only numbness and no obvious pain", the operation could begin.

Dr. Zhou took tweezers and pliers and first explored the inside of the wound, picking out any blood clots, suspected necrosis, residual dirt, and foreign bodies from the human body, and then rinsed it again with normal saline. Finally, dampen the gauze with dry gauze.

After looking at the slightly bleeding red tissue in the wound, Dr. Zhou smiled and said to the patient: "If you are injured on the outside, it is easy for dirt to get inside the wound. We rinse it several times before suturing it to avoid the possibility of infection in the future. Just keep it low, and there will be less trouble during the wound healing process. Don't worry."

"No need to worry, no need to worry." The patient was lying on the bed. Even after local anesthesia, the wound did not hurt, but there was an occasional pulling sensation. In his opinion, this was much easier than before.He asked: "Is my wound easy to treat?"

"It's okay. Just wait patiently and it will be taken care of soon." Dr. Zhou continued to say gently.

When the patient heard the comforting words, he felt much more relaxed and less nervous.

(End of this chapter)