Those years when I hung up and upgraded in the hospital

Chapter 49 Accepting orders in danger (please collect and read)

"Director Peng." After Fang Yun changed into surgical clothes, surgical mask and hat and entered the operating room, he still didn't understand what was going on.

Looking back at the operating table, I saw that there were quite a few people in the department.

Director Peng Nanbo, Lu Sheng, Huang Xuepei and Luo Su, the old chief surgeon of their own group, were all waiting in the operating room.

Just as Peng Nanbo was about to speak, someone behind Fang Yun stepped on the foot-operated sensor door of the operating room.Surprisingly, the director of Fang Yun's team also arrived in the operating room.

No matter how he looked at this battle, Fang Yun felt that something was wrong.

The patient hasn't come in yet, why are so many people coming at the same time?Is this still an emergency surgery?Or a minor surgery?

When Peng Nanbo saw that almost everyone had arrived, he looked at Fang Yun and asked: "Xiao Fang, what kind of tendon suturing method did you talk about with Director Long last time? What do you mean? Can you repeat it again?"

The different forms of suturing are cognition, and whether they can be performed is level.

Hearing this, Fang Yun glanced left and right.

Luo Su touched his nose at this moment, because the stage had not started yet, so he could move quite freely: "Director Peng, tendon suture is slightly different from the Achilles tendon suture that Doctor Fang mentioned last time. The Achilles tendon is a special tendon. "

“Regarding the suturing of tendons, the current mainstream suturing methods include Tan’s suture, Kessler suture, Bunnell suture and Krakow suture.”

It was clear that Rossu had done his homework before entering the operating room.

Fang Yun nodded when he heard this: "When the Achilles tendon is ruptured, Tan's suture is generally not chosen. However, for ordinary tendon suturing, it depends on the patient's injury to choose a more appropriate suture method."

Fang Yun had some knowledge of the suturing methods listed by Luo Su.

Among them, Tan's suture has the strongest applicability. It can not only provide strong connection and stability, but also be suitable for situations that need to withstand greater tension. It can also reduce the risk of postoperative scar formation because the sutures will be buried in the tendons. A loop is formed within.

But the disadvantage is that the time is relatively long, and it is more suitable for tendon injuries that require greater tension support, such as tendon injuries after hand trauma. For patients who are not life-threatening and can withstand the injury, the time can be extended, but the operation is difficult. .

Likewise, the Krakow suture reduces the risk of postoperative scabbing and scarring because the sutures are located inside the tendon.Can be used for internal tendon injuries, such as injuries to the middle part of the tendon.

May not be suitable for all cases of tendon injury.

Peng Nanbo thought for a moment and said, "Let's do it this way. After the patient comes, we'll sew it up first."

"The patient is the child of an associate professor in the emergency department of the Second Affiliated Hospital of Shonan University. He recently came to his grandma's house to play and accidentally cut the pads of his index and middle fingers. After examination at a lower-level hospital, it was found that he had tendon injuries."

"That Professor Du just asked Professor Wang from the Trauma Surgery Department of the Second Hospital to call me and ask me to deal with it temporarily."

"Facing such relatives of professors from higher-level hospitals, we still need to make preparation plans and choose a more appropriate suturing method."

"after all?"

"Just give him a transfer time to go to the Second Affiliated Hospital of Shonan University for the second-stage revision surgery, but don't make mistakes or taboos, and it's best not to look too amateurish."

How to put it, if you are just an ordinary patient, after all, others will not laugh at you.

But for people in the industry, after the surgery, it looks like a complete joke in the eyes of others. Then when you go out for meetings and exchanges, you won't be able to laugh at it.

It’s not that we want to provide better and more sophisticated technology, the county hospital is only at this level.

"Professor Wang from the Hand Surgery Department of the Second Hospital suggested using Kessler's suture to deal with it, or better yet, using Tan's suture."

Peng Nanbo emphasized again: "Professor Wang is a trauma surgeon, but the surgical direction he performs is hand surgery. The hand surgery and trauma surgery of the Second Hospital have not yet been separated."

"Xiao Fang, what do you think?" "We have studied it, and if we have to watch videos to learn it now, we will definitely not be able to learn it. Can you complete the basic elements of Tan's suture or Kessler suture?"

Whether it is possible or not is a matter of cognition. Whether the operation is good or not is a matter of proficiency.

This is also an act of emergency.

The Orthopedics Department of the county hospital was not established to deal with hand surgery and tendon injuries, but only to deal with fractures and fatal trauma. There was no preparation for this before, so how could we find a temporary solution?
Even if we invite experts from the state hospital, it will take two hours to go back and forth, and other experts must be available. With these two hours, Professor Du from Shashi will probably arrive soon.

After all, he is his own child, so after his hand was injured, he still took it very seriously!

"As long as we can lay a temporary foundation and then send him to Shashi for recovery," Peng Nanbo said.

Equivalently, as long as Fang Yun completes a simple form.

This is not difficult. Fang Yun nodded: "If you don't absolutely require the function, I can try to complete it."

"Do you have any MRI or pictures of the appearance?"

Peng Nanbo shook his head: "The CT scan in the town hospital is terrible. Where can we get MRI? In our county, except for the Hospital of Traditional Chinese Medicine and our People's Hospital, no other hospital has equipment like MRI."

MRI machines are very expensive.

"But there are general pictures, but not much can be seen. It should be a rupture of the flexor tendon, but whether it is a full-thickness rupture, it is difficult to say yet."

"Come and see..."

Fang Yun and Long Quan both walked in.

……

Ten minutes later, the child was sent to the hospital. He was about eight or nine years old.

I cut my hand while playing with a sickle.At the town hospital, blood was drawn temporarily and the patient was simply bandaged to stop the bleeding. Because he was informed in advance, he was sent directly to the operating room of the county hospital without delay from the emergency department.

The current preoperative examination has been completed in the town hospital.

After entering the operating room, the child was still crying, but she was still sensible. After being comforted and given nerve block anesthesia, she lost her sense of pain, and she looked around innocently again.

Fang Yun and Long Quan came on stage to conduct exploration first, while Peng Nanbo reported and communicated with Professor Du: "Professor Du, is it a full-thickness injury to the flexor tendon?"

"What? Partition?"

This seems to have touched upon Peng Nanbo's blind spot in knowledge.

Fang Yun replied: "The index finger and middle finger are two areas, and the ring finger is one area."

The index finger and the index finger are called differently.

The area II mentioned by Fang Yun is the division of the flexor tendon, also called the tendon sheath area: this area is from the middle of the middle phalanx to the distal palmar crease plane.There are two superficial and deep digital flexor tendons in this area. The tendons are located in the digital flexor tendon sheaths and have poor blood supply. Therefore, surgical treatment of tendon injuries in this area is more difficult and the effect is poor.

Zone I, profundus tendon insertion area: This area is from the insertion point of the distal phalanx tendon to the middle of the middle phalanx body. This area has only one flexor digitorum profundus tendon or flexor pollicis longus tendon, which is partially wrapped in the tendon sheath, with a constant The short tendon has a good blood supply source and the movement of the tendon is small. Early repair after rupture is better.

"There are two districts and one district." Peng Nanbo repeated.

"Director Peng, please deal with it first..." The other party sighed heavily. Apparently he also felt that the damage in Zone II was particularly troublesome, but there was nothing he could do.

(End of this chapter)