One Hundred and Thirtieth, What a Pity

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Surgical skills and talent are one aspect, but they still need a lot of practice. In the past few decades, the medical system emphasized technology rather than skills.

At the beginning there was a joke that the experts in the tertiary hospitals would not catch a cold. It sounded funny, but it was actually true. Then the country thought that if this continues, the overall medical education will catch up with the nationalization, but Nima’s medical level is getting worse and worse. up.

Only then did the standardized training system come into being, with its advantages and disadvantages as well.

Simply put, medical education is actually technology, and practical application is skill. In this regard, tea has suffered a lot. After Cha Su Hospital had just started to improve, Zhang Fan and Ouyang went south to recruit.

Many doctors and masters with excellent academic qualifications and school grades were recruited, but within two years, they did not perform as well in the hospital as their grades.

On the one hand, it is related to the fact that tea is a factor in primary hospitals, and on the other hand, it has an inseparable relationship with medical education.

The group of people back then could read books, take exams, write papers and do experiments, but Nima couldn’t see a doctor. Internal medicine is better, but in surgery, one counts as one, and there are two or three doctors who have not obtained basic surgery so far.

Fortunately, Chasu has an international medical university, otherwise these doctors would be called non-performing assets.

For example, Li Cunhou's team originally said that they were participants in the invention, and that they should be better than others in the application of materials for allograft transplantation. But what is unexpected is that this group of people includes Li Cunhou. Once the difficulty of the operation increases, they will sit on wax.

As for the mean, the whole can almost be said to be the ceiling of Huaguo Medical.

Surgeon and Surgeon: Zhang Fan, when Zhang Fan flew the knife in the past, it was very embarrassing to fill in the operation records.

Before the anesthesia and before opening the surgical package, the itinerant nurse has to confirm the list of surgeons again, and even if they know it in their hearts, they have to ask it out in the operating room.

This is one of the supervisory powers of the traveling nurse. In the past, when I went to other places to throw knives and met a smarter nurse, I would say, Zhang Fan is the chief surgeon, Dean Zhang.

Although this statement is wrong, it sounds better after all, because in the operating room, this kind of confirmation does not refer to administrative positions, but professional titles.

For example, the director refers to a high-level doctor, not the director in charge of the department.

There are also honest ones who directly shout out that the chief surgeon is Zhang Fan, a resident doctor.

Not only Zhang Fan was embarrassed, but the director who invited Zhang Fan to throw the knife was also embarrassed.

It's all right now, it's not as embarrassing as it used to be. Dr. Zhang Fan, the chief surgeon, sounds very angry.

First assistant Academician Li Cunhou,

The second assistant is Ma Yusheng, the deputy chief doctor of the Department of Dermatology.

In fact, when he was on the operating table, Director Ma replaced him with Li Cunhou's help. Li Cunhou was helping to prepare consumables for allogeneic transplantation on the instrument table of the instrument nurse.

Working with Li Cunhou, when Zhang Fan did it, it was as if he was working with someone who was slow. Obviously they all went in, waiting for the other party's response, but they didn't wait, and when they continued to the next step, this guy screamed out, making Zhang Fan who was about to take the second step nervous.

He only reacted at this time, and they all went in.

Fortunately, after working with Li Cunhou a lot, Zhang Fan got used to it.

But working with Director Ma is different. From the moment Zhang Fan holds the knife, it feels different.

How to describe this, it's like a muscular man meets a muscular woman, there is back and forth, and it can also give the other party a sense of urgency.

It's like the feeling that a muscular girl is always tensing her muscles to come up.

Skin cutting, stretching, and hemostasis, all without talking, let alone Zhang Fan holding tweezers to give hints.

The movements of each step are perfectly coordinated, where Zhang Fan's knife is, his suction device is there, where Zhang Fan's scissors are, his tweezers are there.

Moreover, after all, it is Director Ma who is an old surgeon. On the operating table, he can better understand how to pose for Zhang Fan to make Zhang Fan more comfortable. This is definitely not driving, but a serious fact.

This is why before going to the operating table, a chief surgeon must first determine the first assistant. As for the other assistants, it is enough to have hands and be obedient.

This operation was very difficult, but Zhang Fan performed it very comfortably. Because Director Ma Ma Yusheng has high feeding skills.

Neither of them spoke or even made eye contact, just a hand-to-hand blend.

The more comfortable and faster the surgery was, the more satisfied Zhang Fan felt.

Compared with Ma Yusheng's operation, Li Cunhou's operation is like a middle-aged man's task, so he gritted his teeth.

"A three-centimeter wedge!"

Zhang Fan said softly, without raising his head, Li Cunhou watched the progress of the operation on the operating table, and immediately made a wedge-shaped skin graft about three centimeters.

This stuff is not good for surgery, but he is good at making materials. For example, the material near the child's chin must have a certain curvature, so he made it very well. It is not too big or too small.

To be honest, Lao Li really ruined this pair of poisonous eyes by not becoming an appliance dealer.

After the complete resection of the hemangioma, the serious difficulty of the operation came.

Although the child's face is small, the corresponding face transplant area is larger. Firstly, point-like vascular flaps distributed under the skin graft should be established.

How to describe it, this thing is like a small nest on a potato, and this small nest is for germination.

The vascular valve is for this purpose. When the vascular valve is made well and then covered with the foreign skin, countless vascular networks will be slowly derived like spider webs, and these vascular networks can provide nutrients to the foreign skin.

The allogeneic skin will survive and slowly absorb, and finally there is hardly any difference on the face. This is why Lao Li can be an academician.

Bit by bit, the four hands, four different cuts, cross each other non-stop, intersect with each other non-stop.

At this time, the movement between the tweezers and the pliers is like a mouth-to-mouth feeding between dead young couples, which is not exaggerated at all.

Little by little, gently cover the baby's face, just like a girl's mask before going to bed, gently cover it.

Then use wet gauze dipped in physiological saline, gently push it slowly with your fingers, and apply it little by little. At this time, no excess or bulging areas must be left.

This kind of small bulge seems to be indifferent now. Once it is stitched up, when the child returns to normal, with luck, maybe this place is a dimple.

But if you are unlucky, if this place is not handled well, it will be like a willow disease, and a meatball will grow.

The doctor didn't dare to gamble, and couldn't gamble, One Finger was wrapped in wet gauze, and pushed little by little.

Finally, the hardest part comes, the stitching.

For other operations, during the suturing period, the surgery is almost finished, but not in dermatology, where the final suture is often the most difficult part.

If the suture is not good, the easiest thing is to recover and heal poorly. People who have undergone surgery may have encountered incisions that did not heal.

This kind of suture is very troublesome if it does not heal with a few stitches.

It was as if a child's mouth had been added to the stomach, not to mention pus and water flowed every day, and he had to endure torture-like dressing changes every day.

And this kind of suture on the face is afraid of not healing, and even more afraid of a large number of thick scars after healing.

Almost no sutures are mentioned in all surgeries, and only dermatology surgeries emphasize a fine suture.

What is fine stitching.

Zhang Fan sutured with a microscope.

Zhang Fan and Ma Yusheng are like pirates, each with a microscope on each eye. The small round needles are much smaller than embroidery needles, and all the surgical instruments are extraordinarily small.

With two pairs of big hands resting on the child's face, there is only a little space left for manipulation.

In this gap, the two performed unimaginable movements.

Pushing forward bit by bit, the child's lower jaw started, Zhang Fan probed, and Ma Yusheng could only kneel down.

The child's position is too difficult to manipulate. Zhang Fan is a little ahead, and Ma Yusheng can only retreat, but the jaw is so big, not much bigger than a small cake. In this position, Ma Yusheng can only half-kneel and raise his head to operate from the side. .

It was uncomfortable for Zhang Fan to stretch his neck and half bend over, and it was even more uncomfortable for Ma Yusheng to half kneel and raise his head.

However, I can only persist in this way, gritting my teeth and persisting.

He could only hope that Zhang Fan would be faster, and he couldn't be urged, the more he urged, the slower he would become, and the more he urged, the weaker he would become.

The stitching of the jaw makes the doctor uncomfortable, and the stitching of the nasal cavity and eye sockets directly makes the doctor collapse.

Especially for the suturing of the parts derived from the inside and outside of the nasal cavity, which was originally a small hole, now two instruments need to be inserted into it for suturing, and a knot must be tied inside.

In this kind of operation, every time a knot is tied, both of them shut up and hold their breath, waiting for the two pairs of big eyes, just like a pair of male and female toads staring at each other.

Bit by bit, the sutures were done slowly, but time passed quickly.

Outside the operating room, the child's parents, from the irritability at the beginning, slowly became listless, and finally lost their strength.

Even the eyes of the two didn't have the strength to meet.

The people waiting were like this, and the doctors in the operating room were even more exhausted.

The itinerant nurses have changed twice.

Finally, after the last stitch between the eyebrows was cut, the operation on the child's face was finally completed.

Due to the long-term facial manipulation, the child's fleshy face has now become as round as a silver plate.

Especially the sutures on both sides were swollen like a small head in a balloon filled with clear water.

However, the stitching of the operation was really good, except for a faint circle of red scars, there was hardly any stitching visible.

"It's really good, it's the same as the original skin when it's covered with this material!" Lao Li said boastfully.

"It's a pity!" Zhang Fan let out a long sigh.

Originally, after the operation, not only the doctor was happy, but even the anesthesia and nurses in the operating room had a sense of joy and even a sense of accomplishment.

Everyone gathered together to look at the baby. The wine red color that was frightening was gone. Although the face was swollen like a big egg, it was no longer scary at this time.

But Zhang Fan let out a long sigh, which made everyone feel so tense.

Didn't the surgery go well?

Ma Yusheng's face immediately turned extremely ugly! (to be continued)