Chapter 480

When Zhang Fan arrived in the operating room, the anesthesia director just came out of the office. When he saw Zhang Fan, he smiled bitterly.

"Zhang Yuan, the fat patient in the Department of orthopedics is too troublesome!"

"What's the matter?" Zhang Fan asked curiously.

"You will know when you enter the operating room. I won't say it first. I just called me and asked me to help lift people."

"OK, you go first. I'll come after I change my clothes." Zhang Fan nodded.

The head nurse of the operating room specially made a small dressing room for Zhang Fan. Although it was small, it had a small sofa and a small table.

Change your hand washing clothes, wear your hat and mask.

The hand washing clothes in the hospital look tattered because they are made of pure cotton, and because they are often disinfected by high pressure and high temperature, and soaked with disinfectant from time to time. They can be worn on the body, but they are very comfortable.

Because it is a pure cotton product, it will not be like some century old boutique clothes, covered with static electricity, crackling on the road.

When he walked into the operating room, Zhang Fan almost laughed. Fat boss because it's a broken Achilles tendon in his right leg.

The trousers just took off the right side, and the white fat legs and fat meat hung on the edge of the operating table, just as the Unsmoked fat meat hung on the wall beam.

Operating beds in China. In the early years, there were some products of magic capital in the hospital, with a nameplate: Magic capital No. 3 operating instrument factory.

I don't know why. It is estimated that they can't make money or there is too little money. In the middle and late 1990s, Chinese products were launched by a large margin, and there was a medical market.

The old-fashioned operating table is very crude. If you want to move the operating table, don't think about it without 20 strong men.

What is the old-fashioned operating bed like? Most people really don't have any concept.

It's not easy to explain. I can only say it briefly.

Older people don't know if they remember the state-owned barber shop.

There are several aunts inside, with some very comfortable chairs.

There is a big iron lump under the chair. There are magical gear rods around the chair, which can turn and fall down as a bed.

After putting this chair, it is actually an operating table.

The earliest surgeons were all part-time barbers. So many things in the operating room in the early years were very similar to those in the barber shop.

Even now, the three color rotating signs hanging at the door of many barber shops actually represent arteries, veins, blood vessels and nerves.

The products of the third instrument factory of modu were eliminated by the third-class hospitals in the past few years. Because of Marubeni and Germany, they have developed new operating beds.

Their operating beds have all become automatic and remote-controlled. And because of the battery, you can run as an electric car at the critical moment.

This function looks like chicken ribs, but in a critical moment, it can save lives.

The things in meatball country are very stingy. The bed is not expensive, but there are many additional things. The total price is up to heaven. A surgeon, millions!

However, hospitals in developed cities support counterpart hospitals in the West.

The operating beds in the teasu hospital are relatively advanced and all made in Germany.

However, even after the extension plate of the operating bed has been opened, after the fat boss lies on it, part of his meat is still hanging on the edge of the bed.

"Zhang Yuan! We can only put a small table under his feet.

However, the height can't be adjusted. It may be more tired after surgery. "

The head nurse was also helping. After seeing Zhang Fan, the head nurse stood up and bent down. It was too troublesome, because... Wang Wang certainly didn't understand.

"OK, put a suitable table." Zhang Fan has no choice. The height of the operating table can be adjusted, but the general table does not have this function.

The table can't adjust its height and position. It's only the doctor who can adjust himself.

What do you mean by kneeling for surgery or squatting for surgery? It sounds like bullshit. In fact, this is the routine operation of many special operations.

"Zhang Yuan, the patient's weight is too big. You can't give too much anesthetic, otherwise the dose will exceed the standard." The anesthesiologist began to talk about the problem.

"Discuss this with the anesthesiologist." This Zhang Fan really doesn't dare to intervene.

Medicine is divided into several university disciplines. Let's not talk about the others, but the anesthesia and clinical disciplines involved in the operation are directly different disciplines.

Zhang Fan really didn't dare to give people any advice.

"It is estimated that the anesthetic effect is not good and the weight is too large. When you operate in Zhang hospital, try to speed up."

The director of the anesthesiology department is also helpless. For patients of this type, the amount of anesthetics is too difficult to control.

The effect of less drugs is not good. More drugs may keep patients awake forever.

"OK." Zhang Fan promised, then looked at Xu Xian and Wang Yanan, "who raised your feet?"

"Er!" Xu Xianhan came down. Isn't that why Ming pendulum asked him to lift his feet. Zhang Fan is the leader and Wang Yanan is the girl. He is the only one.

However, looking at the fat boss's elephant thick legs, he is a little bad.

……

"Hehe, where can Xu Xian lift his legs? I disinfect. Don't worry, I'm fast!"

Although wearing a mask, you can see Wang Yanan's eyes. Everyone knows that she is very happy.

Disinfection, surgical disinfection is very strict. Generally, it is required to disinfect to about 15cm of the knife edge.

Because of the rupture of the Achilles tendon, the patient must lift his lower limbs, start from the Achilles tendon and disinfect until near the lower edge of the knee.

Moreover, the toe seam is the key point. Here is a place to hide filth, rich sweat glands, and the skin thickens and forms wrinkles for wear resistance.

This is also the reason why some people's feet can stink dogs even though they have no beriberi.

Wang Yanan began disinfection after washing his hands. The disinfection of lower limb surgery is not troublesome. Conventional disinfection is OK, but it's too much trouble for people who lift their feet.

From the place where the lower leg is connected to the foot, Wang Yanan began to disinfect with oval pliers and iodophor cotton balls.

At this time, Xu Xian grabbed the patient's instep with both hands and lifted it hard. Her legs were too thick.

When Xu Xian was lifted more than ten centimeters away from the bed, he used all his strength to eat milk. Under the mask, he just showed his teeth.

At this time, it's time to test Xu Xian's strength. Is it the Kirin arm.

With Wang Yanan's disinfection scope becoming narrower and narrower.

Xu Xian began to grasp the patient's instep with both hands and slowly became a thumb holding the patient's big foot.

Not to mention it, Wang Yanan had to wipe the patient's feet back and forth with an iodophor cotton ball in his oval pliers.

This calf, at least 30 pounds! Xu Xian held her breath.

Red face, red neck, one hand holding the wrist of the other hand, the thumb and index finger of the other hand, tightly holding the thumb of the meat.

Xin Kui has been single for many years. Otherwise, people who get married early may not be able to mention this action.

Xu Xian's heart shouted again, "ah! Ah! Ah! Come on, come on, shit is coming out! "

Wang Yanan was very fast. In the end, only one big foot and thumb were left without disinfection.

As soon as she turned around and turned back to back with Zhang Fan, Zhang Fan quickly spread the small sheet in the operation bag on the operation bed.

"All right, let it go!"

Xu Xian, gently put down the patient's feet, sweat, directly soaked his hand washing clothes.

While gasping for breath, he pinched the Kirin finger of his right hand, which he often exercises.

Wang Yanan finally disinfected his big toe and took a pair of sterile gloves from the operation nurse.

"This is not good. It's too small. How big is the largest surgical glove in our hospital." Wang Yanan asked.

Because the toe is relatively contaminated and too close to the surgical area, it must be wrapped with gloves.

"Eight and a half!"

"Change to eight and a half."

Girls' surgical gloves are generally size six and a half, boys who are thinner are size seven, and boys with larger hands are size seven and a half, or size eight.

Zhang Fan is 1.8 meters tall and usually takes No. 7 and a half. It is conceivable how fat the fat boss's feet must be, and the thinner pig's feet are not as heavy as his.

Put on your gloves. Shop sheets, four small sheets on the left and right, two middle sheets on the top and bottom, and a hole towel in the middle.

When these lists were covered, the fat boss's fat was gone.

Only a fleshy foot with a rubber hat stood alone on the green operation sheet.

The fat feet stained with Iodophor are as fat as the laughing insects in the cartoon.

Sports medicine is not very good in Asian countries. Bangzi country's medical system is a direct copy of the European and American system.

But they found another way to lead the world trend in plastic surgery.

Don't underestimate this plastic surgery. Bonzi country accounts for the majority of authoritative experts in spinal plastic surgery. As for facial plastic surgery, they have rushed out of the universe.

Although the medical system of Marubeni is not very famous, it is the most perfect country integrating traditional Chinese and Western medicine.

Especially in terms of endoscope, no one in the world is the opponent of others.

As long as we talk about endoscopy, we can't bypass Marubeni. An Olympus endoscope is directly a contrarian thing.

Muscle can be divided into three categories: myocardium, smooth muscle (muscle in visceral and vascular wall) and skeletal muscle.

Skeletal muscle, on the other hand, has too many categories. Long and short, with muscles in the shape of feathers.

The most peculiar is orbicularis muscle. The muscle structure of lips and anus is similar. It's like a wrench made of rubber.

And there are Chinese medical experts who treat hemorrhoids and directly do acupuncture and moxibustion in the mouth, but strangely, it is effective for hemorrhoids!

Skeletal muscle is like a rubber band stuck to two bones.

When the brain gives orders, skeletal muscles begin to contract and stretch, pulling the connected bones to make various actions.

This is also the only muscle that the brain can command. The heart muscle and smooth muscle do not cock the brain directly. People have their own system.

Skeletal movement, mobilize a lot of muscles, synergistic synergy, antagonistic antagonism. Without coordinated muscles, you can't make fine movements.

Without antagonistic muscles, a simple action of playing football may break the knee.

The muscle of the lower leg is the muscle abdomen in the middle and the tendons at both ends. One section is hung on the femur and the other is hung at the lowest end of the lower leg.

Stretching depends on the muscle belly of skeletal muscle, while fixation depends on tendon. The tensile strength of tendon is more than 100 times that of muscle abdomen.

Why have you heard of tendon rupture but not muscle rupture? Although the tendon is strong and tough, it has no contractile function.

Therefore, when violence occurs, the tendon will sacrifice itself to absorb a lot of energy, thus protecting the bone and muscle abdomen.

Tendon rupture, as long as there is a little tear, it is a rupture. And in terms of time, it can be divided into acute fracture and chronic fracture.

Many athletes have fallen out with their teams because of this acute and chronic problem.

There's a story in this. Tendons can be said to have no blood vessels to supply nutrition. It lives on a thin film covering the surface of its muscles.

The nutrition in the blood is distributed to the membrane, and then to the tendon after the membrane is finished. As you get older, the less nutrients the membrane conveys, and the more easily tendons are injured.

Acute tendon rupture, which is operated within 48 hours, is called acute rupture, and the recovery is relatively better. Once more than 48 hours, it is called chronic tendon rupture.

Once more than 48 hours, regardless of surgery or conservative treatment, it is very troublesome, and the effect after recovery is also very poor.

However, after tendon rupture surgery, athletes may not continue to maintain competitive state.

As long as the tendon is not completely broken, many teams give athletes pain relief and closure needles, and then wrap some fixation measures.

In this way, we can continue to let athletes play. As for the future of athletes, this is not what they consider.

Therefore, athletes often fall out with the team after tendon injury. Yao's thumb tendon, I don't know why I chose conservative treatment, but

The gold standard for tendon repair is open surgical repair. The effect of plaster fixation and wearing inflatable walking boots is not as good as that of open surgery.

Fat people have a lot of fat. Fat is a very strange thing. As long as it is something that the human body eats, whether it is alcohol or nutrition, it should be tasted.

Fat boss, it's more than two hundred kilograms, full of fat meat. If you taste it casually, the amount of medicine you need is terrible. The anesthesiologist really didn't dare to give it again. He was afraid that the fat man would never wake up again.

With the stable anesthesia, the fat man quickly entered the sleep state. Zhang Fan, Wang Yanan and Xu Xian also started the operation.

"Alcohol, sharp knife. Hurry up, there's not enough anesthetic. " Zhang Fan said quickly and began to disinfect the knife.

When the scalpel cuts through the skin, they don't have to wait for Zhang Fan. Their blunt separation, full yellow fat particles, directly squeeze out of the wound like pinching Japanese tofu.

"It's too fat. The draw hook is too slippery to hang!" Wang Yanan tried to hang up for a long time, but he didn't hang on to the fat man's skin. There was too much fat and too oily.

"Electric knife, suction device." Zhang Fan ignored Wang Yanan. As the bleeding was stopped by Zhang Fan with an electric knife, a trace of smoke rose.

There is a saying in surgery: you can judge the level of the surgeon from the smell of electric paste in the operating room.

Electric knife electrocoagulation, pay attention to point to point, move quickly and quickly.

When the smell of burning hair comes out, the doctor's level can be said to be extremely poor.

Because he roasted the hair follicles in the skin with an electric knife, the use of an electric knife is absolutely prohibited.

The smell of a lot of coquettish and smelly burnt smell shows that the doctor's level is average

It must be that the blood vessels are not clearly seen. Instead of point hemostasis, it is a direct flat discharge knife and large-area electrocoagulation.

Only the faint smell of barbecue. Such as roasted fat meat, the smell of meat when cooked but not charred can arouse appetite.

Well, the doctor is a master at least in the use of electric knife.

Of course, Zhang Fan's electric knife is absolutely master level. He doesn't know how many times he has used it in the system.

When he uses an electric knife, especially at the meal point, he can definitely hear someone swallowing.

Don't talk about others. Sometimes even Zhang Fan himself will be greedy for the smoke he makes.

Superb technology, so far.

The ultimate art is art.

……

Of course, if the bleeding is severe, Zhang Fan won't use an electric knife and just hang a thread and sew it up.

The knife edge of tendon repair is very long. For the choice of knife edge, some doctors believe in small knife edge, while others like big mouth.

Zhang Fan believes in a word: everything is based on reality, not dogma.

The healing of the incision is from one side to the other, not from one end to the other. A suitable knife edge is the beginning of an operation.

The sharp blade swam gently in the fat, like an iron boat breaking the waves on the Yellow Lake.

Open the skin and cut through the fat. The fat boss's tendon was exposed in front of Zhang Fan.