Auto chess in the operating room

Chapter 76 Dressing Change Practice
In the first week, Tang Lou started his dressing practice.

The purpose of dressing change is to prevent surgical infection, that is, infectious diseases and trauma that require surgical treatment, as well as concurrent infection after surgery.

Tang Lou was in the dressing room, finished washing his hands, put on a mask and hat, and the regular dressing changes that Xu Lanlan had prepared for him early:
Sterile cotton swabs, sterile saline, 3% hydrogen peroxide, 0.5% iodophor, erythromycin eye ointment, sterile dressings, breathable adhesive tape, etc.

The one who needed to change the dressing was a patient who had suffered an explosion in a chemical plant before, and the wound on his right leg had some suppuration.

Tang Lou adjusted the patient to an appropriate position, not only to ensure the patient's comfort, but also to make it easy for him to change the dressing.

The patient's leg was burned by fire before. Although the wound was debrided, after a few days, the central part of the wound was still necrotic and liquefied. The yellow pus was filled with a large number of pathogenic bacteria and neutral cells, and the outside was covered by a complete cavity wall. , also known as an abscess.

According to the previous experience in the classroom, Tang Lou disinfected the patient's skin and performed local infiltration anesthesia.

After that, it was cut layer by layer. Since the technique had not yet been exchanged, Tanglou's movements were naturally a bit jerky. As for the way to wield the knife, he chose the bow-holding posture.

The bow-holding style is one of the surgical knife-handling methods, and the bow-holding style is the most commonly used, that is, the thumb is under the knife handle, the index finger and middle finger are on the knife handle, and force is exerted through the wrist.

It is often used for longer skin incisions, and is obviously ideal for patients with large abscesses at this time.

Tang Lou cut through the patient's deep fascia after concentrating on making several cuts. The sharp tip of the knife entered the thick cavity, and Tang Lou hadn't exerted any force yet.

Yellow juice overflowed from the knife edge, thick as snot, and mixed with some blood.

Tang Lou put down the razor blade, and squeezed lightly with his hands wearing transparent thin gloves, like squeezing a pimple that was ten times magnified.

The blood-yellow liquid flowed out continuously, until only the bright red blood remained, Tang Lou stopped bleeding and cleaned up.

Tang Lou held the knife again, this time using the pen-holding style, that is, the way of holding the pen. The force of the movement is mainly on the fingertips. This method is used for short-distance and delicate operations.

It is also the method that Tanglou is most familiar with. Before using this method in the laboratory, he often dissected the blood vessels and nerves of mice.

Of course, Tang Lou was extremely cautious when using it on a human body for the first time, cutting up the necrotic tissue of the patient bit by bit.

It took a full 5 minutes for Tang Lou to remove the necrotic tissue.

After carefully appreciating the cleaned wound, Tang Lou began to apply dressings to carefully cover the wound.

After the completion, start to wrap the patient's wound with white gauze, compress and bandage.

Naturally, the dressing wasn't finished yet, so Tang Lou checked again to make sure the wound didn't ooze.
It took about half an hour for Tang Lou to complete the dressing change of the first patient.

[Mission: Devil special training.Complete a patient case of dressing change, reward 1 gold coin, and the card is automatically refreshed]

Tang Lou looked at his panel:

Level 3: Upgrade 12
Surgery column (3/3): suture (three stars, 9), diagnosis (one star, 3), emergency comprehensive (three stars, 9)

Gold: 7
Fetters: None
Talent (2/2): 1. Stitching assembly line (activated): 2. Listening (active skill, one-day cooldown)
Storage slot (1/9): Debridement (two stars, 6)

...

[Deck library refresh: Dressing (one star, 1), suture (one star, 1), incision (one star, 1), hemostasis (one star, 1), exposure (one star, 1 )]

...

Tang Lou directly selected four at a time: dressing change (one star, 1), incision (one star, 1), hemostasis (one star, 1), exposure (one star, 1)

Level 3: Upgrade 12
Operation column (3/3): Suture (three stars, 9), diagnosis (one star, 3), dressing change (one star, 1)

Gold: 3
羁绊（1/1）：外科圣手（一级，2/5）：患者感染率减少20%，愈合速度增加20%
Talent (2/2): 1. Stitching assembly line (activated): 2. Listening (active skill, one-day cooldown)
Storage column (5/9): debridement (two stars, 6), incision (one star, 1), hemostasis (one star, 1), exposure (one star, 1), emergency comprehensive (three stars, 9)

After completing a dressing change in the tenement building, Xu Lanlan soon arranged for the second patient to come over, while cleaning up the mess left by the tenement building.

"Doctor Xiao Tang, the patients you need for dressing change have already been screened for you, and four of them have been arranged for you in the morning."

Tang Lou went to the side to continue disinfection and various preparations before changing the dressing, and at the same time ordered:
"Okay, oh, yes, the last one in the morning, arrange a suture case for me."

Xu Lanlan was a little puzzled, looked at Tang Lou, and persuaded:
"Dr. Xiao Tang, no one knows that your suturing skills are already good enough. Director Shen also said that there is no need to practice suturing. This week, you only need to change the dressing."

Naturally, Tang Lou couldn't explain it. He owns a suture assembly line, and he can recover his energy just by suturing a patient. The last case at noon, and the one in the afternoon, keep the feeling."

Listening to Tang Lou's words, Xu Lanlan looked at Tang Lou with admiration, and nodded: "As expected of Doctor Xiao Tang, no wonder he is so good at stitching. You are so diligent."

The wound of the second patient was on the abdomen, and the dressing was changed just yesterday. It may be that the previous intern did not operate well, the pus was not drained, or the disinfection was not careful.

The superficial dressing has been soaked with purulent exudate and needs to be replaced.

Tang Lou carefully pulled out the vaseline oil gauze, and used hydrogen peroxide cotton balls, 0.1% chlorhexidine solution cotton balls and 0.9% normal saline to rinse the wound repeatedly.

Since there was no anesthesia, the patient grimaced in pain during the dressing change, but since Tang Lou was equipped with a one-star dressing change technique, generally speaking, he had a more professional technique.

Tang Lou controlled his strength. In order to stimulate the growth of granulation tissue, Tang Lou picked up the dressing tweezers and gently scratched the wound edge until a small amount of blood flowed out. He then used saline gauze to drain the wound and promote the fresh granulation from the wound. The wounds are healed from deep to shallow.

After doing all this carefully, Tang Lou adjusted his standing posture and turned his neck slightly.

"Doctor Tang, you have worked hard."

The patient lay flat on the bed, looked at Tang Lou, said with gratitude and embarrassment.

"It's okay, it will be over soon. Generally speaking, your wound is healing well. After I change your dressing today, it will heal faster."

As a result of inspiring a master surgeon, Tang Lou naturally spoke to the patient confidently.

"Really? But, Doctor Tang, your technique is really much better than that little doctor yesterday, and the pain is much less."

The patient was hesitant about Tanglou's claim of rapid healing, but he could still feel the lighter pain intuitively.

After treating the inside, Tang Lou covered the outer layer with a clean and disinfected dressing.

"From now on, I will change the dressing for you once a day, and it will heal in about 5 days."

Tang Lou said confidently.

"Really? That's great."

Although the patient was lying down and couldn't get up, he still tapped his jaw lightly. The doctor Leng yesterday was really unreliable, and said that it would take at least 7 days to heal.

When Tang Lou was trying to change the dressing, outside the dressing room, through the big glass, Huo Tong nodded in satisfaction. Tang Lou's serious efforts made him very satisfied, and he took out his phone:
"Liu Tong, go and discuss with other departments, and send all suitable patients to the general surgery department, carefully screen them, and try to keep them under control."

(End of this chapter)