My medical skills add experience

Chapter 476 Snobbish family members, infection caused by artificial materials

It's just that the Third Hospital was the first to hit Tuya Hospital with its idea, which is a bit like a silly rabbit picking grass on the edge of the nest.

Zhou Can began to study this rotten patient carefully.

The patient was diagnosed with a sternal tumor and underwent extensive sternotomy and chest wall reconstruction.

At present, the patient has postoperative incision infection and sternal osteomyelitis, resulting in long-term non-healing of the wound.

The Third Hospital has thought of many ways to treat the patients, but unfortunately, there has been no effect.The family members worried that the patient would die in the third hospital if he continued to treat him.So he 'actively' requested to be transferred to another hospital.

According to the introduction of the family members, the doctors and nurses of the Third Hospital, including the family members of the patients in the same room, all said that the medical skills of Tuya Hospital are excellent.

Two days before the transfer, when the nurse gave the patient infusion, severe edema occurred due to long-term infusion at the site where the indwelling needle was placed.

When switching to the other hand to get the needle, the nurse made a mistake, and it took three consecutive pricks to get the vein.

The original bed doctor asked for leave due to family affairs, and a new bed doctor was replaced. He was frizzy and extremely irresponsible.When family members and patients reported problems to the doctor in charge of the bed, they also pushed back and forth in a perfunctory manner.

At this time, a family member of a patient in the same ward secretly told them that the Department of Cardiothoracic Surgery of Tuya Hospital had recently cured many difficult cases.

The family members are heartbroken.

Strongly request transfer to hospital for treatment.

The corners of Zhou Can's mouth twitched. Aren't these coquettish operations in Xinxiang Hospital just to persuade patients to transfer?The family members don't understand the truth, but he knows it well.

Another interesting point is that Xinxiang Hospital tried their best to praise Tuya Hospital's excellent medical skills. Is this from the heart, or has it received Tuya Hospital's kindness and gave Tuya Hospital some rewards?
This kind of thing is really hard to say.

It may be a bit nonsense to talk about repaying gratitude.

Back then, Xinxiang Hospital followed the Provincial People's Hospital and the Third Hospital to encircle and plunder Tuya's cardiothoracic surgery business.

It may be that Tuya Hospital sent a team of experts to Xinxiang Hospital for consultation, which left an indelible impression on them.

Tuya's strength has penetrated into the hearts of the medical staff of Xinxiang Hospital.

In addition, Tuya's cardiothoracic surgery has been very high-profile recently, and every once in a while, many difficult cases that have been successfully cured or have obvious effects are brought out for publicity.It also gives a powerful impression to outsiders.

The cause of this patient is clear, that is, postoperative infection, accompanied by sternal osteomyelitis.

The difficulty lies in the treatment.

Xinxiang Hospital gave various anti-infection treatments after the patient developed postoperative infection.It's a pity that I can't control it at all.

Sometimes, antibiotics are not a panacea.

Especially for some serious infections, the simple use of antibiotics seems a little weak.

To use the simplest analogy, there is an abscess in the patient's body, and symptoms of infection and inflammation appear.At this time, antibiotics are used for intravenous infusion.As long as the abscess exists, no matter how much antibiotics are infused, it can only suppress the condition, but it is difficult to cure.

The correct approach must be to first draw out the pus in the abscess cavity, then clear the abscess cavity, and then use antibiotics after ensuring that there is no source of infection.

Only in this way can the purpose of healing be achieved.

Plus, the use of any kind of antibiotic comes at the expense of damaging the immune system.

Really qualified and experienced doctors are cautious when using antibiotics.

Some patients especially like to go to small clinics for drips, and they go to infusion for treatment when they have a little headache.It often takes effect very quickly, and it will be fine as soon as the infusion is given.But the next time I caught a cold, it was more serious.

This is because the use of antibiotics weakens the immune system.

In recent years, many domestic pediatric experts have pointed out that most breastfeeding babies who have a cold and fever can recover on their own with the help of antibodies in breast milk.Every time the baby heals itself through its own immunity, the body's immunity will become stronger.

This is equivalent to the fact that after a baby comes to this new world, in order to adapt to the environment, the immune system is naturally tempered again and again.

If some family members take the baby to the hospital for injections and medication because they love the baby too much, this will cause the baby's immune system to miss good opportunities to exercise again and again.

After weaning, the bodies of these children have significantly weaker resistance.

Therefore, in recent years, the voice of advocating breastfeeding has become louder and louder.

It can not only prevent babies from drinking poisonous milk powder, but also enhance the baby's immunity with the help of natural antibodies carried by breast milk.

Xinxiang Hospital's postoperative treatment for this patient is mainly anti-infection.

This is somewhat similar to the abscess treatment mentioned above, where the abscess cavity is not cleared, and only antibiotics are given.

First, find the source of the infection and find a way to get rid of it, and then supplement it with antibiotics, so that it can be cured.

From this perspective, it can be seen that Xinxiang Hospital's background is insufficient.

Sternectomy and chest wall reconstruction did not bother the surgeons at Xinxiang Hospital.However, there was a problem with postoperative management, and the retreatment of postoperative infection directly stumped them.

Zhou Can began to carefully sort out each operation link, as well as various postoperative examinations performed by patients.

The operation is not complicated. The basic steps are general anesthesia, endotracheal intubation, and then determining the location of the malignant tumor in the sternum and selecting the incision.

Cut the skin and subcutaneous tissue to expose the sternal lesion and cut off the muscles attached to the sternum.

The lesion and some of the surrounding normal tissue were then resected.

For the resection of this kind of malignant tumor, as long as a surgeon with a little experience will choose to cut more, he will not be relentless.

Because some seemingly normal adjacent tissues may have metastasized tumor cells.

Incomplete surgery is very dangerous.

The patient will relapse again very quickly.

The vast majority of malignant tumors grow more stimulated.

A typical dao is one foot high and a demon is one foot high.

Excision of the lesion was standard and not problematic.

Zhou Can locked his eyes on the chest wall reconstruction surgery that will follow.

Because the patient had no preoperative infection, artificial materials were chosen for chest wall reconstruction.

They chose plexiglass panels.

After the reconstruction of the chest wall, Xinxiang Hospital placed a drainage tube when suturing the incision according to the surgical requirements.

Such a postoperative defect is large, and a drainage tube must be placed.

Only in the case of small chest wall defect, the incision can be directly sutured without drainage.

"Could the problem be on the artificial material?"

Zhou Can's surgery experience is rich and well-informed, and he has been taught by Director Hu Kan.

After some combing, combined with the patient's symptoms, he quickly identified the most likely cause of postoperative infection.

Zhou Can has experienced the perfunctory attitude of the medical staff in Xinxiang Hospital.

The possibility of infection caused by improper postoperative care cannot be ruled out.

He decided to visit the patient in the ward for further diagnosis.

When he came to the ward, he saw this patient, male, in his 40s.

The patient's medical record information shows that he is 48 years old.

Fifty knows destiny.

48 years old is already an age that is not too old. At this time, the body's metabolic level and recovery ability are not as good as those of young lads.

It can be clearly seen that the incision on the patient's chest is infected.

Because of the continuous use of antibiotics, there was redness and swelling, but no obvious suppuration.

The situation is relatively ideal.

It is estimated that the cardiothoracic surgery department has already passed the checkpoint when accepting patients.It is really serious, and patients who have a high probability of death will naturally not be admitted.

"How do you feel now?"

Zhou Can finished checking and asked the patient.

Since ancient times, diagnosis is expected to be heard and asked.Asking the patient how they feel can help the doctor better understand the patient's condition.

Why is pediatrics difficult to treat?
Because many children under the age of three will not clearly express where the pain is or where the body is uncomfortable.

I only know that it is uncomfortable.

Seeing this kind of 'dumb department', the doctor will be more laborious.

"It hurts! I have a fever and I can't eat..."

The patient was struggling to speak, with a painful expression on his face.

When speaking, it is drawn to the wound on the chest, causing pain.

If the wound is not infected and heals gradually, this problem will not occur.

"Doctor, if you have any questions, I can accompany you to the office to chat. My dad is feeling very uncomfortable now. I have already expressed any symptoms to your bed doctor and Director Xue. Please understand and try not to ask these same questions repeatedly. .”

The patient's daughter was wearing a fur coat, high heels, and black tight leggings.

Even in the ward to accompany her, she still draws her eyebrows and wears bright lipstick.

He is not very old, about 24 or [-] years old.

Guazi has a pointed chin, delicate facial features, and big eyes. She is quite beautiful and juicy.

It's just that he is not polite at all, and looks very strong.

"The patient's condition is constantly progressing and changing, and the symptoms will be different. We ask the patient's latest feelings every day. It seems to be repeating the same question, but we are responsible for the patient. If there is any new change, we can also discovered in time."

Zhou Can has long been able to be calm and calm when dealing with such sharp-talking family members.

"Okay, okay, I can't break you. If there is any new situation with my dad in the future, I will find the bed doctor in time, or report to Director Xue during the ward rounds. Please try not to disturb my dad's rest. Yes You can ask me any questions anytime."

The woman said impatiently.

She obviously regarded Zhou Can as an ordinary doctor, but she didn't know that this person in front of her was even better than Director Xue.

"understood!"

Zhou Can nodded and walked out of the ward.

It is extremely unwise to quarrel with family members.

Some family members think they know a little about the hospital hierarchy. During the hospitalization of their loved ones, the chief physician is the person they dare not offend.Secondly, I will try my best to curry favor with the doctor who manages the bed.

As for nurses and other doctors, they are too lazy to wait on them.

In any case, it does not affect the treatment of patients.

Of course, when encountering such snobbish family members, nurses and other general doctors often feel particularly wronged and feel a little offended.But few people care about it.

These days, it's not just the uncle who owes money, but the grandson who needs to pay.

In the hospital, some patients and their family members hold the trump card of complaints in their hands, and they are actually in front of the hospital's uncle.

Because they think the consumer is God.

They spend money to see a doctor, so they naturally want to enjoy God-like treatment.

It can only be said that medical care should never be a service industry, but a resource.It is a precious resource that can save lives at critical moments, cure diseases when sick, and restore patients to health.

If doctors and nurses treat patients and their families with smiles and bow their knees like waiters in restaurants, that is definitely the tragedy of all patients.

In developed countries, a new medical industry, private medical teams, is gradually emerging.

When patients are sick, as long as they can afford it, this team can provide the highest quality medical services, and they are absolutely professional.The only downside is that the price is a bit expensive. Even in the beautiful country, one treatment may directly bankrupt a middle-level family.

Many people are sick and would rather die at home than be dragged away for treatment.

Because it's too expensive, it can't be cured at all.

Zhou Can returned to the office and continued to think about the reasons for the postoperative infection of this surgical patient.

"If the inference is correct, it should be that the patient used artificial materials in the reconstruction of the chest wall. This non-vascular reconstruction material leads to difficult healing, coupled with inadequate care, which leads to postoperative infection."

[Pathological diagnosis experience +1, reward pathological diagnosis experience +100.]

Sure enough.

His eyes became brighter.

At this time, Director Xue heard that Zhou Can was coming after the operation, and took the initiative to look for him in the big office.

"Zhou Can, I heard that you just went to the ward to find out about the condition of the patient in bed 73. That patient is a refractory patient who underwent surgery in Xinxiang Hospital and developed a postoperative infection. Is there any progress?"

After she divorced her husband, she put her focus on work, and managed to get through the saddest period with the help of high-intensity work pressure.

Zhou Can and Director Le knew that she was divorced, and they also gave her a lot of extra care.

I just heard that her husband is really not a thing. After the divorce, the fight for property is very fierce.Even the only house has to be occupied, so Director Xueyan can only rent a house now.

In the process of confrontation between women and men, they are ultimately in a weak position.

The men occupy the house, and there are not many men in the woman's natal family, so it is difficult to get them back.

If a woman dares to snatch it, she will probably be beaten.

The only way is through the law, but it will take time.

Director Xueyan told Zhou Can about this, and her idea was to give up the fight for the house, as long as she could really break up with the man, and stop pestering her in the future.In addition, she gave up the house in exchange for custody of her children.

This is a family matter, Zhou Can not only respects, but also gives some help within his ability.

"There has been some progress. I suspect that the patient suffered from postoperative infection. It is likely that the artificial material used in the reconstruction of the chest wall increased the difficulty of wound healing, coupled with improper postoperative care, which caused the infection."

In fact, any wound that has difficulty healing is not a good thing.

Even with proper care, the risk of infection will increase exponentially.

"I also suspect that it is caused by artificial materials. Just remove the artificial materials and perform simple soft tissue reconstruction. I am worried that the patient's thorax will become unstable. Do you have any good solutions?"

Director Xueyan and Zhou Can are both director Hu Kan's high-achieving apprentices, and her level of diagnosis in cardiothoracic surgery is also very high.

"There are ways to do it. Anyway, a second operation is needed. It is better to have a larger operation again. This time, it can be reconstructed with autogenous bone. Ribs are actually an ideal material."

Zhou Can proposed a surgical plan.

(End of this chapter)