The road to the rise of great doctors

Chapter 89 The working atmosphere is harmonious (Please collect and read)

Zhao Gang saw the first operation performed by Liu Dong, and recalled himself back then.At this time, his mood was the same as that of Dr. Zhu Guoliang from the Department of Urology.

The self in memory seemed to be sublimated in an instant.Um, yes, it must have been too long ago, and my memory at that time was biased. I was not that good at that time!
His impression of Liu Dong also improved a lot. At first, he felt that "hearing is false and seeing is believing."When he heard Deputy Chief Physician Zhang Wei talk about the emergency surgery, he felt that the situation was a bit exaggerated, "How can a new clinical intern be a qualified first aid?"

However, after getting in touch with him today, Zhao Gang discovered that "it is true that he is a real person despite his reputation."

For outpatient minor surgeries, the “minor” refers to the overall minimal trauma to the patient, but the difficulty is not necessarily that low, especially when the number of cases is small.Most doctors can only accomplish this skillfully after accumulating many times of experience.However, according to his observation, Liu Dong was very skillful in the operation, unhurried, concise, and with very few redundant movements. Some places could be seen to be a little jerky, but he was able to do it completely for the first time. , is already a leader among his peers or including graduate doctors.Moreover, Liu Dong is modest and not rigid.

Zhao Gang agreed with Zhang Wei's point of view, "Liu Dong's future achievements are very impressive."

In the short term, the two of them should cooperate more harmoniously in the next clinical work. In clinical practice, the workload is so heavy. If you meet a person who is cheating and cheating, then the other person will have to do less work. The workload of people is taken up.And Liu Dong should not be that kind of person.

In addition, having such a skilled person made him feel much more at ease about the upcoming surgery.When you encounter an emergency, you can call for help; when you are in trouble, Liu Dong can act as a first aid, and the two leaders in the team should be more likely to accept his request for leave.

The second procedure was still a surface tumor resection.

He was the main surgeon and Liu Dong was the assistant.

After completing it, Zhao Gang found that he was not as miserable as he remembered.Compared with the current Liu Dong, the current self is still no less generous.Suddenly, his mood became much more stable.

The third one was a patient with pigmented nevus. Because she was a young girl, she requested cosmetic sutures.Therefore, Zhao Gang decided to suture it himself.

Pigmented nevus is also a common disease that requires outpatient surgery.It is a neoplasm or stain formed by the disorganization and aggregation of pigment cells.Depending on the location and hospital, diagnosis and treatment may be performed by different departments such as plastic surgery, general surgery, and dermatology surgery.

At the Medical College Affiliated Hospital, it depends on which department the patient goes to for treatment.The dermatology department here does not have dermatology surgery, and patients are basically referred to general surgery or plastic surgery for surgical treatment.

Generally speaking, there are two main reasons why pigmented nevus requires treatment. One is that it affects the appearance, and the other is the fear of malignant transformation.Others are things you can do or not do, it all depends on your choice.

"Liu Dong, do you know when you are more worried about the malignant transformation of pigmented nevus?" Before waiting for the patient to come in, watching Liu Dong prepare surgical supplies, Zhao Gang instantly stepped into the role of a teacher and asked questions.

Liu Dong had already done some review over the weekend and did not panic when he encountered this problem. He immediately said, "The main signs of malignant transformation of pigmented nevus are the following. If one of them appears, you should be alert: First, size: sudden change in a short period of time." Increase in size; second, color: darker or uneven color; third, border: originally the border of the nevus was very clear, but now the border of the nevus is blurred and expanding radially; fourth, periphery: pigment appears around the nevus Rings, pigmented dots or small satellite moles; fifth, hair: there was hair before, but suddenly fell off for unknown reasons; sixth, symptoms: there were no accompanying symptoms before, but now there is slight itching, burning, and pain in the local area; seventh, physical signs : The surface skin used to be intact, but now the surface is prone to bleeding, scabs or ulcers." After the patient came in, the two began to operate.

After routine disinfection and draping, Zhao Gang performed local infiltration anesthesia, and then began to excise along the edge of the pigmented nevus.During the excision, a portion of the surrounding normal skin is included.

This girl only came for surgery because she "felt unsightly." Liu Dong took a look and felt that it was not a malignant transformation.

Therefore, during surgery, the main thing is to achieve "complete excision + cosmetic suturing".At the beginning of the excision, the lines were simply drawn and designed to avoid difficulty in suturing, which would not be a cosmetic suture.

While cooperating, Liu Dong imagined in his mind that if it was a malignant lesion, there would be other precautions: "The nevus and the surrounding normal skin need to be removed 3 cm, and the full thickness of the skin needs to be removed." Then he found that if it was a malignant lesion, If more skin is removed without extending the incision, the suture tension will be relatively high, and a thicker thread will be needed. There will probably be obvious marks after the incision is made.

In that case, if you want to achieve the effect of "cosmetic suture", you should extend the incision appropriately, so that the suture tension should be smaller. The suture line can also be finer, and the subcutaneous suture should also be sutured. Disperse tension.

The mental assumptions did not affect Liu Dong's cooperation, and the overall surgical process was relatively smooth.But despite considering that there was no malignant lesion, we still communicated with the girl and sent him for a pathological examination. "What we can see with the naked eye is very consistent with the pathological examination, but sending a pathological examination is to exclude situations that have a very low incidence but may have serious consequences, even if it is Malignant lesions are estimated to be very early and the risk level is relatively low."

The girl also accepted and agreed.

The subsequent surgery was uneventful. Liu Dong basically completed the resection of the body surface tumor himself, while Zhao Gang provided guidance.

He watched Liu Dong become more and more proficient in operations and assisted by instruments. In some cases where he himself needed help, Liu Dong used small pliers and finger pulling to complete the task.He was not jealous, but felt that he had learned some skills from Liu Dong.This also made him realize more and more that the rise of some people may be truly talented, and these people may "fly" quickly if given a chance.

At that time, as a former teacher, he should have some bragging rights.

"Come on, you have been very helpful today. A new Maocai restaurant has opened opposite the hospital. If you have no dietary restrictions, I will invite you to eat." Zhao Gang smiled and extended an invitation to Liu Dong.

He has no shortage of humanity and sophistication.Mental adjustment, for him, is the norm at work.

"Okay, thank you, Brother Zhao." Liu Dong was also very cooperative.
(End of this chapter)