Doctor's Life Simulator

Chapter 60 Who Teach Who?Wu Youtu: The Clown Is Actually Myself

You Daren continued the operation very rigorously and earnestly:

"Qin Lang, the next step is to roll the pedicle of the skin flap into a 5-7cm leather tube. The root of the skin tube should leave 2-3cm without direct suturing at the opposite edge, and Y should be done with the skin donor area at the root of the skin tube. Type suture treatment."

Wu Youtu on the side looked at Qin Lang silently, thinking that he couldn't understand the mystery, and thought, after all, he was still young and saw many things, but he couldn't figure out the mystery, thinking he had learned it all.

When you actually do it, you will find that you just swallowed the jujube whole, and the details are still far behind!

Wu Youtu reminded softly: "Qin Lang, after watching Dr. You's operation, do you think that's the case."

Qin Lang took it for granted, nodded his head, it is indeed quite ordinary, did not expect Wu Youtu to have such vision?
Seeing Qin Lang's seemingly ignorant reaction, Wu Youtu thought it was true, and said sternly: "Xiao Qin, in fact, Dr. You's operation just now is very subtle, and the reason why he didn't directly perform relative suture is to avoid strangulation of blood vessels at the root of the skin. Affect the survival of the flap."

Qin Lang's expression changed slightly, hey, he really overestimated Wu's rule.

Seeing Qin Lang's silence, Wu Youtu followed You Daren's operation and continued to output:

"Xiao Qin, let me tell you, you should pay attention to this operation by Dr. You in the future. When the artery diameter is small, in order to improve the chance of successful anastomosis, you can cut the femoral artery at the beginning of the artery. The venous disc is 0.5-1.0 cm, or the common trunk vessel is used to form a disc and the vessel in the recipient area is anastomosed"

Qin Lang continued to remain silent, thinking of a famous saying in his heart:

"The stinky chess basket plays chess with the stinky chess basket. The more you play, the more stinky it becomes. Although Doctor You's level is not bad, it is obvious that all of them are flaws. If it weren't for the extra billions of surgeries, Wu Youtu would have fooled him." .”

After a long half an hour, Dr. You finally completed the whole operation, quite satisfied, and looked at Qin Lang with a cold expression:

"Qin Lang, basically this is the whole process of free flap transplantation. After that, it's postoperative care. Postoperative flap observation is particularly important, and it should be fixed, bleeding and blood supply."

"The quality of the skin flap fixation directly affects the success or failure of the operation. If the skin flap is not fixed firmly and the body moves, it will cause the pedicle to twist, hinder blood circulation, and delay the healing time. It may even make the skin The petal failed. So you have to remember this, and I learned it from the painful lesson."

Qin Lang nodded. Indeed, in the simulated world, he also encountered this problem at the beginning.

"In addition, the bleeding of the skin flap is also abnormal. When there is a small amount of bleeding, you can use sandbags to stop the bleeding. If there is a large amount of bleeding, the flap will harden and the pressure will cause skin flap necrosis, so ligation should be performed immediately."

Qin Lang hummed lightly, through You Daren's experience, he can basically judge his level, a child can be taught, no wonder in the simulated world, after his master-level operation, he can comprehend a breakthrough from it.

In order to be able to better judge You Daren's stage, Qin Lang took the initiative to ask. He has already judged his surgical operation, but the postoperative treatment is still unclear, and asked:

"What about the flap blood supply?"

"In terms of flap blood supply, wound blood supply should be checked 6-7 hours after surgery, especially 1d-2d after surgery is the most important. When checking, it is necessary to check whether there is any pedicle reflexion, torsion, and compression at the suture site at the far end of the flap. wait."

After You Daren answered in detail, Qin Lang nodded slightly after listening to it, and continued to ask:
"Then how to observe the skin condition of the flap?"

You Daren was secretly surprised, Qin Lang's question was so detailed, remembering that Director Wei also inspected him in such a comprehensive and systematic way, he couldn't help but smile:
"For the skin color, temperature, redness test, and skin elasticity of the skin flap, if the skin color is rosy, the skin temperature is normal, the redness test is good, and it is elastic, it means that the blood supply is good. If the skin color is pale or Bruising, low skin temperature, exudation or odor from the wound dressing, timely treatment measures should be taken”

After listening to Qin Lang, he also became interested, and was ready to help You Daren go further, so he asked pointedly:

"Dr. You, I still have a few questions. How should I fix it if the flap is too small to cover the wound completely?"

Hearing Qin Lang's question, Wu Youtu on the side was a little puzzled, this little guy, what are you asking?
Then, You Daren was slightly taken aback, just now he made a small negligence in the process of cutting the skin flap, the cut was too small, but he took the incision in time to extend the outer edge of the pedicle of the flap, thinking it was a cover-up very good.

Now that I think about it, it is true that the solution just now was not the best way. You Daren recalled:
"In addition to extending the incision at the outer edge of the flap pedicle, we can also use the flap to cover the exposed bones, joints, nerves, blood vessels, and tendons in the wound as much as possible, and then treat it according to the situation of the remaining wound. A single pedicle flap was cut from one side for transfer."

After Qin Lang heard it, You Daren's handling method was quite satisfactory, but it was still a bit short, and he would show it to himself when he had a chance.

"Then, Dr. You, when separating the flap, how do you avoid damaging the arterial arch and its communicating branches at the upper edge of the abductor muscle?"

When You Daren heard this, he was startled again, and thought about it in his head, as if he hadn't thought about this question.

Suddenly, cold sweat broke out on his back, recalling his operation, he really almost damaged the artery on the upper edge of the abductor muscle just now, Qin Lang asked whether it was a coincidence, or was he keenly aware of the small flaws in my operation ?Can't.

When You Daren was thinking, Wu Youtu on the side was a little confused, so what kind of questions did this little Qin ask, and they were not on point.

"Xiao Qin, you can't chew as much as you want, okay, then you will try the second one, and Dr. You and I will give you instructions."

You Daren glanced at Wu Youtu gratefully, he really couldn't answer Qin Lang's tricky question.

Taking a deep breath, You Daren also regained his confidence: "Yes, our task today is still very heavy, and there are still several operations to be done. Qin Lang, you master the most basic operations first, and then we will discuss these details."

"Okay then, there are two Laos."

Qin Lang thought for a while, then wait a while during the operation, and show the little tricks by himself, hoping that You Daren can learn the essence from it.

As for Wu Youtu, from his Wu Yan and Wu Dialects, it is known that he has not yet reached this level and cannot understand.

Soon the three of them made preoperative preparations. This patient had a skin defect on the back of the ankle joint with Achilles tendon and exposed calcaneus. It must be said that Wu Youtu and You Daren chose this patient for Qin Lang. Patients are very targeted.

[Ding, the new task, through the patient's operation, showing the detailed operation, let You Daren and Wu Youtu have a breakthrough.Task reward: 1 life simulation point. 】

(End of this chapter)