Auto chess in the operating room

Chapter 101 Textbook-Level Teaching of Abdominal Disinfection
In order to be able to see Tang Tianlinsheng clearly, Tang Lou deliberately did it slowly, explaining the tricks and key points while doing it.

Tian Linsheng was a little confused when he heard it, and naturally he couldn't understand it immediately if he didn't experience it personally. Qingping, who was on the side, had the feeling of exchanging ideas with his peers to confirm his experience.

"beautiful~"

Qing Ping said sincerely, Tang Lou soon began to clean up the pus from the pelvic floor and the right paracolon ditch.

After checking that there was no bleeding and counting the equipment, Tang Lou stood aside.

"Tian Linsheng, next you will finish closing the abdomen."

Tian Linsheng trembled with excitement as if he was listening to the sounds of heaven, and another wave of nervousness struck him, and he walked cautiously to the operating table.

He glanced at Tang Lou nervously: "Doctor Tang, I'm starting."

There was a bit of trembling in the words, seeing Tian Linsheng's reaction, Qingping also smiled knowingly, this is the reaction of a normal person.

Compared to Tanglou, it is a monster!

Qingping still remembers that after the first time the abdomen was closed and sutured, he lost sleep for several days in order to ensure the tightness of the closure.
".needle pliers, needle and thread"

Tian Linsheng recalled Ma En's previous operations. After all, Tang Lou's movements were too fluent and fast, which was not suitable for him.

Holding the needle-holding forceps, Tian Linsheng was already in a cold sweat, his hands were still trembling a little. He practiced with pork yesterday, but he was still a little flustered when he got into a real person.

Especially this patient is a bit obese, and the fat layer is relatively thick. When Tian Linsheng was suturing the anterior sheath of the rectus abdominis muscle, he suddenly found that he could not distinguish the anterior sheath and the subcutaneous fat tissue.

"I"

Tian Linsheng was about to cry, but he thought this was his first suture, swallowed his saliva, bit his head, and the movements he had practiced several times in his mind became a little stiff.
Tang Lou taught the stitches and margins yesterday, and he had long forgotten. The most terrifying thing was that Tian Linsheng obviously felt that he was pulling slightly, but the peritoneum was directly torn.

"!!!"

If he had a mobile phone now, Tian Linsheng would really like to post a Moments: "What if the patient's peritoneum is torn by sutures during the operation, wait online? It's very urgent!!!"

At this time, Qingping couldn't bear it anymore: "Tian Linsheng, how is your anatomy?"

Hearing Qingping's voice, Tian Linsheng trembled, blushing and guilty: "It's so-so."

Qingping: "Then do you know where the carotid artery is?"

Tian Linsheng: "Huh?"

Qingping: "You change the needle forceps into a scalpel, and scratch it."

Tian Linsheng's soul has already left his body: "???"

Qingping: "With your kind of suturing, the patient won't get better anyway, so just give him a good time."

Tian Linsheng: "."

Chen Wenhao covered his mouth, and said with joy in his heart: "It's started, it's started! Doctor Qing is pissing off people online!"

As soon as Qingping's voice fell, Tang Lou's face was dark and unwilling to show weakness:
"Tian Linsheng, I gave you extra lessons for nothing yesterday. I don't think you should learn suturing in the future. You should work hard to learn the repair of large-scale maxillofacial tissue defects, which is more suitable for you!"

Tian Linsheng wanted to say in his heart: "Boss, please speak your mind!"

Of course he knew that what Tang Lou said was definitely not a good one, but when the chief surgeon lectured, even if he knew that it was a critical attack, he still had to pretend to be cute and cooperative.

Tian Linsheng showed his eight teeth professionally, and smiled slightly: "I will study hard."

Tanglou: "Well, after you learn it, do it for me. If you teach a student like you, I have no choice but to let go of my extremely handsome face."

Qingping: "."

Chen Wenhao: "."

Sure enough, the surgeons scolded each other more and more ruthlessly.

After the two jokes, Tian Linsheng's stiff limbs relaxed a little, but his heart hurt a little, and he wanted to cut his arteries and have a cheek surgery.

In this way, no one will know who is the rookie who died of stupidity because he couldn't do a good job of shutting down the abdomen.

Seeing that Tian Linsheng had recovered his thinking, Tang Lou said seriously:

"Although the patient's fat layer is relatively thick, there is no need for sutures. Sutures will only increase the chance of foreign body incision fluid overflowing, and the skin should not be too densely sutured. Knotted skin can be close to the top, and don't be too tight. Too tight will affect the blood flow." It is very important to remove the subcutaneous necrotic fat, flush the incision and accurately stop the subcutaneous hemorrhage.”

"what!"

It was only then that Tian Linsheng realized that one of his own was strangled too tightly, and the other was that the sutured part of his mother's body was simply fatty tissue, so what was peritoneum!
I said so!Why did it torn.

Tian Linsheng, you must be stupid to yourself
°(°°)°

"What did I tell you yesterday? The techniques for suturing the abdomen are: wide, loose, full-thickness, wide stitches, and appropriate margins. Under anesthesia, tighten the sutures forcefully, wake up from anesthesia, and the patient's abdomen is bulging. You can imagine it yourself." This is how the tofu is cut with a thread."

Tang Lou continued to complain about Tian Linsheng.

Tian Linsheng's face was so hot that he could fry an egg, but he really admired him in his heart. As an intern, Tang Lou's understanding of Guanfu was too deep.

Qing Ping on the side also nodded frequently, what Tang Lou said was even more detailed than him, almost at the textbook level.

"No wonder this guy is like a veteran in the first surgery, and his theoretical knowledge is really solid!"

The more you operate with Tang Lou, the more you can understand his strength.

Chen Wenhao on the side also had a serious face, there is something in Tanglou.

Tang Lou's tone has become serious:

Tian Linsheng, this patient has a thick fat layer, so we should pay special attention to it.If the suture problem of subcutaneous fat is not handled well, then you are going to face the patient with a fierce face every day.

Subcutaneous fat is sutured intermittently, leaving too many thread knots and foreign bodies, which are the root causes of fat liquefaction and thread head reaction at the operation port.

Some surgical threads react and ooze repeatedly until the last knot is taken out.Moreover, the subcutaneous fat is sutured intermittently. Once infected or liquefied, it will be difficult to expand and drain the subcutaneous fat due to knotted subcutaneous lines.Unless the sutures are removed and the surgical opening is opened.

Tian Linsheng was startled suddenly, so he thought he was smart and prepared to use a more powerful mattress suture.Just about to start, Tang Lou stopped immediately:

It is unnecessary to suture the skin with silk mattress.Skin mattress sutures are difficult to loosely fit the skin, and often need to be knotted too tightly.Will lead to tissue ischemia, is not conducive to drainage.Silk mattress sutures are not recommended except in elderly patients with loose skin.

Tian Linsheng: "!!!"

It's so hard for me, I really want to go back and continue my pull hook.

After Tang Lou pointed out Tian Linsheng's mistake, he began to talk about the way he designed for this obese patient:

"After studying the patient's body shape and medical records yesterday, I made the following suture plan."

Hearing Tang Lou's words, Qingping's eyes lit up, no wonder this guy didn't rush every operation, he did his homework in advance, and even made a special plan for closing his abdomen.

Tian Linsheng was also hit hard in his heart, and then he was extremely admired. It makes sense for him to do well.

What were you doing yesterday?
As much as I could fantasize and think about my first abdominal closure, if I had carefully studied the medical records yesterday, deliberated on the abdominal closure plan in advance, and even consulted Tang Lou in advance, I am afraid that I would not have such a predicament today.

Tian Linsheng, at this moment, really regards Tang Lou as a teacher.

Five-body cast!

Chen Wenhao was also in awe. Tang Lou's rigorous attitude was really hard not to admire.

The pretty nurse has gleaming eyes and is so handsome. She still lives so well.

While several people were shocked, Tang Lou calmly began to explain the abdominal closure plan he designed for the patient:

The first layer: double-strand parallel PDS suture continuous suture with a long line with a margin of 1cm. The central surgical opening includes the peritoneum and the alba linea, and the peritoneum should not be stuck on the abdominal linea alba; the rectus abdominis opening includes the peritoneum and the posterior sheath.

Afraid that Tian Linsheng would not understand, Tang Lou explained the PDS line again:
Since there are many styles of PDS wire, the double-strand parallel PDS wire with two zeros is equivalent to the traditional No. [-] wire.The domestically produced is the so-called Pudis, and the label is also PDS. This thread is also commonly used to suture tendons.

The second layer: for the rectus abdominus.
(End of this chapter)