The Godfather of Surgery

After Xiao Su leaves.

Dean Pan, the health bureau, the township government, and Fang village chief all came to see Yang Ping, expressing gratitude, condolences and apologies.

Tian Yuan reported to Director Han about Yang Ping’s injury. Director Han reacted greatly and ordered Tian Yuan to shorten the time for supporting the side, withdraw troops in advance, and wait for him to notify the specific withdrawal time.

Then the call immediately called Yang Ping, anxiously inquired about the injury, and told him to rest well.

Soon Director Tian and Song Zimo both received calls, and Director Han urged them to take good care of Yang Ping and not to be infected.

After about ten minutes, Director Han's phone call came to Tian Yuan's mobile phone again.

After answering the phone, Director Tian said, "Go back early the day after tomorrow. The hospital will send a car to pick it up. The car will arrive tomorrow. All of our orthopaedic departments will go back early."

"I told Director Han, and Xiao Su followed him back." Director Tian added.

Tian Yuan was very busy, and the phone rang again. Dean Pan, he received a notice from his superiors that because there was an emergency in Sanbo Hospital, several of the medical team had to go back early. "

"Go back early? A patient with chronic osteomyelitis of the femur, Xiao Xu, hasn't the surgery been done yet?" Yang Ping has been thinking about this patient.

Xiaoxu's bacterial culture, the exposed bone was cultured with coagulase-negative staphylococci, and the other bacteria were not cultured, which was in line with the expected judgment, and the surgery could be performed.

Director Tian said, "Just leave the operation to Director Zeng. You explain the main points of the operation clearly."

Yang Ping was not at ease: "That won't work. This operation needs to be very thorough to remove the infected bone tissue. If a little bit is not removed, the operation will fail."

"Then let him come to Sanbo in the future." Director Tian was also embarrassed. The time for the return trip has been set, and it is difficult to change it according to Director Han's temper.

"His economic conditions are not good, and now he has no money to go to the provincial capital." Yang Ping sympathized with Xiao Xu.

"Let's do it tomorrow and let Song Zimo take the lead." Yang Ping said.

He asked Xiao Wu to call Director Zeng, instructed Director Zeng to sterilize the external fixator and supporting instruments in advance, and told the patient to start fasting now and to have a full-length thin-slice CT scan of the femur tomorrow morning; Angiographic color Doppler ultrasound, looking for the recipient arteries at the skin defect site and the donor site arteries at the latissimus dorsi muscle site; then seek medical consultation for perioperative thyroid function management.

"In this patient, every time the imaging examination, the scope of the infected bone tissue has increased. I am afraid that if I don't do it now, if all the femurs are really infected, there will be no chance." Yang Ping explained.

"I have seen this patient's film, and I heard that you are considering local bone tissue infection in the femur. Other imaging abnormalities are caused by hyperthyroidism and bone mineral disease?" Director Tian asked.

"Yes, so remove the infected bone tissue as soon as possible." Yang Ping said.

"Tomorrow I will also come on stage to help Song Zimo." Director Tian was very interested. After arranging the operation, Yang Ping was relieved.

In the evening, Yang Ping rested early.

After entering the system, several experimental subjects were dissected, and the anatomical images of the human body were initially established in the mind.

For doctors, especially surgeons, the ability to compose pictures is very important.

Yang Ping has a strong ability to compose pictures, and through the powerful training of the system, the anatomy of the human body in the brain gradually becomes clearer. With eyes closed, the main internal organs, nerves and blood vessels are clearly visible, but some details need to be further enhanced.

In the system, although the physical energy is not consumed, the mental fatigue still exists, so after not staying for a long time, I come out of the space and sleep.

Early the next morning, Xiao Su came to WeChat, waited outside the dormitory, and went to breakfast with her.

Looking at the corner, Xiao Su fed Yang Ping breakfast bit by bit.

Fatty Liang said, "The first time I saw them, I felt there was a story."

"What story?" Zhang Lin was curious, and there were other stories he didn't know?

Fatty said confidently: "That night, the emergency diagnosis pointed out that Brother Yang had an operation for the first time, and Xiao Su was an instrument nurse, and their eyes were wrong."

"No? No wonder, I've known each other before. You said that my brother went from People's Hospital to Sanbo for Xiao Su, right?" Zhang Lin touched his chin, made bold guesses, and discovered stories. He has talent.

Fatty nodded affirmatively: "80% of the time, the two of them were secretive before. If Brother Yang hadn't injured his hand this time, he would have to hide it. How deep is this hiding?"

Zhang Lin said: "Yes, this guy, some time ago, we suspected that they were going to get married, but the senior brother was stubborn and refused to admit it. Now it seems that our guess is correct."

Xiao Wu was silent by the side.

"Why are you dumb today?" Zhang Lin asked him.

Xiao Wu is also confused now and can't make up his mind.

After the shift was over, Yang Ping was inconvenient to conduct a ward round, and Song Zimo took everyone to a ward round.

After checking the room, in the doctor's office, everyone was preparing to discuss Xiao Xu's condition. There was a lot of noise outside. I was afraid that it was not the patient who was making trouble. Director Zeng got up and said, "I'll go out and have a look."

"Here, here!" Teacher Yan came in with a cane.

His son and daughter-in-law carried a big pennant with a few golden characters on it: Get rid of the disease by hand!

"Director Yang, what's wrong with you?" Teacher Yan exclaimed when he saw Yang Ping's hand.

Yang Ping said with a smile: "Accidentally scratched, it's not in the way."

Teacher Yan nodded: "That's good, you can't have problems with your hands."

The old man instructed his son and daughter-in-law to carry the pennant in. The pennant was big enough, at least three times as big as usual.

"Director Yang, I have nothing to thank you. I'll send you a pennant to express my feelings. I wanted to write a poem, but I held it back for two days.

It was lively for a while, everyone continued to discuss Xiao Xu's condition, and Director Tian also came to the orthopaedic department.

After Xiao Xu finished the CT, he returned to the ward. The doctor in charge of the bed came up with his CT film, and Director Zeng hung the film on the reading light.

"This patient has three main surgical steps: first, remove the intramedullary nail and replace it with an external fixator; second, remove all the diseased bone tissue and fill the bone defect with vancomycin-containing calcium sulfate; third, use The free latissimus dorsi myocutaneous flap is used to repair the defect. The most difficult thing is to remove the infected bone tissue. It needs to be precise and thorough. Every imaging examination of him, the scope of the infected bone tissue is expanding, so we have to re-install the infected bone tissue before surgery. Do a thin-section CT scan to determine the extent of the infection."

Yang Ping briefly explained the steps of the operation, and then carefully read the film in front of the reading light, and said: "In the straight position, the upper edge of the patella is ten centimeters, and a rectangular bone flap is made, eight centimeters long and three centimeters wide, and the midline of the rectangle is this. Segment the midline of the femur. This way the infected bone tissue can be removed completely, and give me a piece of paper."

Someone pulled a piece of A4 paper from the printer, Yang Ping barely held the pen with his tiger's mouth across the gauze bandage, and began to draw on the paper: "This is the shape of infected bone tissue, this is the shape of a cuboid."

Draw an irregular three-dimensional figure on the paper, surrounded by regular cuboids.

"How did you figure it out?" Song Zimo looked at the drawing.

Yang Ping said: "It is constructed based on the CT scan pattern, and 20 percent of normal bone tissue is added around it as a safety zone."

Song Zimo thought, this requires a strong compositional ability. To draw it by yourself, it is estimated that you will need to measure and repeatedly try to draw before you can draw it. ability.

Director Tian helped his glasses: "How much confidence do you have of success?"

"Theoretically, it should not fail." Yang Ping is sure, after all, this range is calculated from CT scans.

"The skin and muscle defects are trimmed into an oval shape, twelve centimeters long and five centimeters wide. The latissimus dorsi myocutaneous flap is routinely increased in area by 20% on this basis. The latissimus dorsi can just repair the defect of the vastus lateralis. ."

The color ultrasound room came up, and the doctor in charge of the bed notified.

Yang Ping and the doctor in the ultrasound room searched for the arteries in the defect area and the latissimus dorsi muscle together, and marked all the available arteries one by one.

A skin flap is to take a piece of skin from one place to fill the missing skin in another part. When the distance is short, the blood vessel can be transferred to the position to fill it. When the distance is far, the blood vessel is cut off and then connected to the blood vessel at the defect site.

The myocutaneous flap is taken together with the muscle and skin, which can not only repair the skin, but also the muscle.

It's a kind of work of tearing down the east wall to make up the west wall.

Yang Ping asked Song Zimo to repair the shape of the defect, and the shape of the flap of the latissimus dorsi muscle was all drawn with a surgical scribe.

"Doctor, when it's done, I'll join the army."

Xiao Xu still remembers being in the army.

Yang Ping looked at him wearing glasses: "You are short-sighted, and you are still a soldier?"

Xiao Xu took it down: "Flat mirror, I'm wearing it to play with."

You can't be a soldier. The young man will know in the future that sometimes there will be contradictions between dreams and reality, and some are irreconcilable contradictions.

The internist looked at the thyroid function data, which did not affect the operation for the time being. After the operation, the thyroid function and drug control were reviewed. During the operation, he went to the operating room to follow the stage to be alert for thyroid storm.

Song Zimo is the main surgeon, Director Tian is the first assistant, and Director Zeng is the second assistant. This operation is not difficult for Song Zimo.

Halfway through, Yang Ping patiently instructed Song Zimo on the precise positioning of the infected bone tissue. Song Zimo also has certain composition skills, which is easy to understand.

The removed bone tissue, Yang Ping repeatedly confirmed, the infected bone tissue has been completely removed, and there is a circle of normal bone tissue around it, which is the most ideal situation.

Chronic osteomyelitis is the most troublesome in orthopedics, and the most feared by orthopedic surgeons. Because the bacteria are hidden in the bone tissue, the antibiotics cannot reach it, and the bacteria cannot be reached. Therefore, once you get chronic osteomyelitis, it will go back and forth again and again, and it will not be cured for many years.

If there is no accident, Xiao Xu should be able to recover this time.