My medical skills add experience

Chapter 489 Another sixth-level medical skill, the meaning of a doctor

"Doctor Yang, let me test you, why do you deliberately leave some peritendon tissue when you harvest the transplanted tendon?"

Zhou Can threw this question to Yang Zhi.

"In order to better fix the tendon?"

Yang Zhi obviously didn't understand either.

According to ordinary people's thinking, some peritendon tissue is reserved when taking the tendon, which can be easily sutured and fixed.

"I ask you, what is the function of tendons?"

Zhou Can asked questions instead of answering.

"It is to help the limbs to complete the movement! For example, the finger flexors and extensor tendons, their function is to help the fingers complete the stretching and flexing movements."

Yang Zhi gave the answer without even thinking about it.

People who study medicine, who doesn't know the function of tendons?
"Why can finger extensor and flexor tendons help fingers move?"

With a smile in his eyes, Zhou Can pressed further.

"Isn't this... because they help the fingers flex and straighten by contracting or relaxing?" Yang Zhi became less and less confident when asked by Zhou Can.

"Dr. Yang's answer didn't hit the point. If the tendons want to help the limbs move, they must first ensure that they can slide smoothly and freely. If the bones are deformed, or the muscles are atrophied and tightened, they may not be able to slide normally. At this time, the body The function of the corresponding parts will be affected. Therefore, when I separate the plantar tendon, I deliberately leave some peritendon tissue in order to allow the transplanted tendon to slide flexibly."

Zhou Can was in a good mood, so he patiently explained the mystery of the operation to the two of them.

These surgical knowledge are not easy to learn in books, and are the valuable experience accumulated by surgeons in clinical practice.

"So that's it! I've learned it!"

Yang Zhi and Pu Dingdong nodded repeatedly, feeling that they had benefited a lot.

The two followed Zhou Can to perform surgery, and they often learned a lot of valuable knowledge about dry goods.

It's not just about surgery, sometimes some rescue experience and ideas for solving problems benefit them greatly.

"Remember, after the distal end of the grafted tendon is fixed, you must test its reliability on the spot. If you find a problem, you must find out the cause and solve it immediately. Don't be careless, and you should suture the incision directly. This will directly lead to The patient still cannot recover the proper finger function after surgery."

Zhou Can warned the two of them.

What is a good teacher?
To be able to teach by precepts and deeds like him, morality, experience, technology, teaching together, this is a real good teacher.

He tested the fixed plantar tendon and it was fine.

Only then will the incisions on the fingers be sutured one by one.

No two medical assistants were called in to do it on their behalf, because this operation is a precision operation with extremely high technical requirements.

Neither Yang Zhi nor Pu Dingdong could meet this requirement.

Next, he placed the wrist in a neutral position and stretched the free tendon stump so that the fingers were in a flexed position 15° greater than the functional position.

Then the flexion of each finger increases from the radial side to the ulnar side.

It's easy to say, but there are many details in operation.

For dynamic muscles, it is necessary to sew a traction thread on the tendon, and then pull the tendon to test the size of its sliding range.until it meets the requirements.

In addition, it is also required to use an injection needle to pass through the skin horizontally and pin it under a state of greater tension.The two tendons were temporarily sutured and fixed, and the fixed needle was pulled out.Then flex the wrist joint 40°, the fingers should be fully straightened, and when the wrist joint is placed in the maximum dorsiflexion position, the fingertips should be within 4cm of the palm crease.

After passing the test, all of them passed the test, and a smile appeared in Zhou Can's eyes.

Hand tendon transplantation mainly requires patience, the operation needs to be extremely delicate, and all the tests during the operation must be in place.

Never try to save trouble.

Also, after the length of the tendon was determined, the proximal end of the free tendon was anastomosed with the deep flexor tendon.

When performing tendon anastomosis, considering the difference in thickness between the reserved superficial flexor tendon and the transplanted plantar tendon, he used the Pulveraft braiding method for fixation.If the size of the root tendon is the same, there is no such trouble, and the conventional suture method can be used directly.

[Stitch experience +1, +1...reward experience +10.]

[Ligation experience +1, bonus experience +10.]

As he continued to sew, his experience points also increased rapidly.

Suture has already been promoted to level six, and ligation is still a little bit worse, but it's almost there.

He is very eager to advance to the sixth level in ligation as soon as possible.

Because suture and ligation are a pair of close comrades-in-arms, inseparable from each other.

It's just that the suture technique is strong, but the ligation technique is always weak. This is definitely not possible.In some difficult operations, ligation is too weak, which will seriously reduce his operation level.

Ligation is slow to advance, mainly because it is difficult to earn large experience rewards.

It is most common to get 10 experience point rewards like just now.

And it is possible to reward ten experience points for stitching, and only one reward for ligation.

This caused the experience value of this medical skill to lag far behind that of suturing.

But don't worry too much, in various operations, the two medical techniques of suture and ligation are extremely frequently used.They are used in almost any surgery, no matter how big or small.

According to the current progress, ligation should not take long to be promoted to level six.

Soon, he completed the anastomosis of the two tendons.

[Anastomosis experience +1, complete ultra-difficult tendon anastomosis, reward experience +1000. 】

The reason why the matching is difficult is mainly reflected in two aspects.One is that the transplanted plantar tendon is different in size from the reserved superficial flexor tendon.The second is that the operating platform for finger-tip anastomosis is small, which is a highly demanding fine operation.

In addition, after the anastomosis, the corresponding effect needs to be achieved to ensure the recovery of hand function.

The technical points and difficulties involved may even make the general chief surgeon feel terrified.

The patient had undergone two operations in a top three hospital in other provinces but failed to be cured, which shows how difficult this operation is.

[Congratulations on your promotion to the sixth level of anastomosis, the current experience value is 1/1000000. 】

Another medical skill was successfully promoted to the sixth level.

In addition to joy, Zhou Can found that he was not so excited anymore, and his mentality remained relatively calm.

It's like after getting a monthly salary of [-] a few times, when I get it again, I feel nothing.

He has already advanced to the sixth level with many medical skills, and his mentality is becoming more and more calm.Now aim for a higher level seven.

I thought it would take at least five to ten years for the first medical skill to be promoted from level five to level six.

Unexpectedly, in less than two years, many medical skills have been promoted to the sixth level in advance.

This was something he didn't expect.

In the past, when his surgical skills were only at the fourth level, the operations he could perform were actually quite limited.Many difficult surgical tasks are mainly based on observation.

At that time, earning 10 extra experience point rewards would make him happy for a long time.

Now almost all of his medical skills have been upgraded to level five or above, and the difficult surgical tasks he can challenge are becoming more and more extensive.This also gave him the opportunity to earn a large amount of experience rewards.

At the highest point, he even earned over [-] experience rewards.

Although it was only once so far, it was enough to make him extremely excited.

According to experience, if there is one time, there will be a second time, and a third time...

Now it is difficult to earn a single experience reward of [-]. That is because he knows that his level is limited and he dare not challenge some extremely difficult surgical tasks.

With the promotion of multiple surgical skills to level six, especially the promotion of advanced medical skills to level six, this gave him the confidence and ambition to challenge more difficult surgeries.

I believe that rewarding 1000 experience points, or even [-] experience points at a time, will become commonplace.

Just like now, it is extremely common to get 10 points or 100 experience point rewards at a time.

The higher the level of his medical skills, the more powerful the diagnosis and treatment tasks he can handle. It may be much shorter than he expected to advance to the seventh level.

At this moment, the tendon anastomosis has been completed, and the newly promoted sixth-level anastomosis cannot be used in this operation.

However, he believes that in the next operation, the six-level anastomosis will definitely bring him a surprise.

Some difficult matching, try now as much as possible.

Including the recognized most difficult nerve anastomosis.

I believe there will be new breakthroughs.

In terms of neural anastomosis, he is very talented in his own right.

I still remember that in the regular training recruitment examination, his anastomosis level was still very weak at that time.However, after anastomosis of the tail nerve of the mouse, it was able to restore some nerve function in the mouse.

Everyone was amazed on the spot, and for other candidates, no matter if it was a doctorate or a master's degree.Whether it's a top student from a famous overseas school or a genius from a top domestic school, they are all beaten by him.

Today, the anastomosis has been promoted to the sixth level, which is the level of the chief physician. I can't imagine what kind of effect will be achieved if he anastomoses the patient's nerves now?
Zhou Can always wanted to repay Dr. Xu's kindness in his heart.

How to repay?

The way of giving a sum of money is too low-level.

And Dr. Xu would definitely not accept it.

The best way to repay is to help the patient who had a medical accident by Dr. Xu get back to health.

As long as Zhou Can can really do this, the patient and his family will regard Zhou Can as a benefactor.At that time, their hatred for Dr. Xu will continue to decrease.

If Zhou Can finds another suitable opportunity to intercede for Dr. Xu, he should be able to help Dr. Xu get rid of the invisible shackles he has worn for many years.

The operation that Dr. Xu performed back then, as Zhou Can's status and strength continued to improve, his influence in the hospital continued to increase.

He asked some other people in the know about the situation.

Although he hasn't been able to check the patient's file for the time being, but based on the details he learned, it can be basically concluded that the nerve anastomosis is the most important item in order to help the patient regain his health.

Therefore, his anastomotic technique was successfully promoted to level six this time, which immediately ignited his confidence in treating that patient.

Because the patient's status is very noble, the people behind him are even afraid of Tuya Hospital.Even if Zhou Can really has the ability to cure that patient now, the family members probably won't agree to take this risk.

Just like the imperial doctors in ancient times, they were often called quack doctors and trash by the emperor.

In fact, it's not that the imperial doctor's medical skills are poor, but that some medicines are not dared to be used at all.

It is a medicine that is three-point poisonous, and a severe case requires a strong medicine.

This is the most basic principle of Chinese medicine.

The princes, princesses, and noble concubines are all golden branches and jade leaves, and their bodies are delicate. What if the medicine does not cure the person, but because of the side effect of the medicine, it kills the person and causes the condition to deteriorate rapidly? What should I do?
Lose your head in minutes!

Therefore, the imperial doctors would rather bear the infamy of quack doctors, and only dare to prescribe some mild prescriptions.

Most of them are prescriptions for invigorating the middle and replenishing qi.

Can be selected by the royal family, enter the palace to become an imperial doctor, enjoy the state's salary support, and treat the doctor for the royal relatives, how can the level be low?
To ordinary people like Zhou Can and Dr. Xu, the patient who had an accident during Dr. Xu's surgery had no difference in status from that of the royal relatives.Even if Zhou Can is willing to take the risk of operating on someone else, he might not agree to it.

I'm afraid this matter has to be discussed in the long run.

In short, what we have to do now is to increase our reputation as much as possible.

This extremely difficult hand tendon transplantation operation came to an end soon.

In this operation, Zhou Can was promoted to the sixth level for both separation and anastomosis.The harvest is huge, beyond imagination.

Through this incident, he deeply realized what it means to be rewarded with good.

When I decided to take this operation, I actually had to take a very high risk.

My heart was beating drums all the time.

Now it seems that it is worth taking some risks appropriately.

The premise is that family members and patients are not the kind of busy people.If he encounters the kind of white-eyed wolf or poisonous snake that may bite the doctor back at any time, Zhou Can will still take defensive medicine like most doctors.

Mutual trust between doctors and patients, and maintaining a kindness that can put themselves in the other person's shoes is really important sometimes.

……

Time flies, and the days pass quickly.

Zhou Can's life and work gradually got rid of the shadow brought by the killer incident and returned to normal.

learn from mistakes.

Now, when he deals with female colleagues and female patients, he will try his best to avoid causing misunderstandings by the other party's boyfriend or husband.

Especially when talking about work with those married female doctors and nurses, if you can open the door, you must open it.

Things that can be negotiated in public places should not be discussed in the office as much as possible.

After a period of hospitalization for the patient with hand tendon transplantation, most of the hand function of his right hand has basically recovered.As for restoring more complete hand function, patients need to undergo a lot of rehabilitation training.

This is a long-term process that may take half a year or even longer.

The patient called the hospital and thanked Zhou Can for his benevolence, which allowed his right hand to recover basic hand functions.

Now, the patient has found a job as a screwdriver.

In his own words, it is very good not only to make money, but also to help the hand function recover better at work.

I heard that after this young man regained his self-confidence, he actually met a girl who was able to talk to him in the factory.

The two are currently dating, and the girl doesn't have any dislike for the young man.

On the contrary, I admire his bravery and tenacity.

If nothing else happens, after this young man has a satisfying job, he can get another girlfriend.

Life is like this sometimes, the harder you work, the luckier you get.

As long as you dare to fight hard and don't give up easily, God may open a new window for you inadvertently.

Zhou Can felt very happy after learning about the postoperative changes in this patient.

It is the most meaningful thing for a doctor to help patients overcome their illness, regain their health, and live a happy life.

On this day, Zhou Can went to work in the hospital as usual in the morning.

During the rounds in the inpatient ward, the nurse ran over to him in a panic, "Dr. Zhou, Dr. Zhou, a shock patient suddenly came outside. Dr. Ai asked you to go over and help with the consultation."

Ellie is a general practitioner in the emergency department and is now in her late 50s.

Still only an attending doctor, which speaks volumes in itself.

(End of this chapter)