Chapter 730 - The Super Scholar's Little Boss
The rising star of the cardiosurgery department stood in the assistant position and focused on the surgical field. All kinds of instruments were placed to one side and as he pulled the retractor, he would hand over the surgical instruments from time to time.
Lu Zewei was stunned for a moment. This was...a scrub nurse's job? Why was he doing such a thing?
He knew that Su Yun had a sharp and unkind temper. Lu Zewei was still very careful even though he was already going to lead a team at Chengdu Provincial Hospital.
He observed the patient's position. He was in a supine position. It should be lumbar anesthesia plus continuous epidural anesthesia. The patient was in a semi-conscious state.
He looked around. It was a routine internal fixation for tibia fractures.
Did Su Yun go end up in the orthopedics department? If he didn't want to be a postgraduate student or a student in the thoracic department, why did he want to go to the orthopedics department?
Lu Zewei's head was dripping with sweat.
"Boss Lu, you're here?" The anesthesiologist saw Lu Zewei walk in, greeting him as he walked back from the patient's feet.
He wiped his sweat with his hands, his eyes filled with excitement.
Lu Zewei knew the look in his eyes very well.
Other than the assistants, the anesthesiologists and scrub nurse were also the people who knew the surgeon's level the best. Because there was no conflict of interest, the anesthesiologists and scrub nurses were even more objective than the assistants when it came to evaluating a surgeon's level.
Although there was no verbal communication, the look in the anesthesiologist's eyes had already betrayed him.
From the look in his eyes, it could be seen that he was an extremely awesome surgeon. The surgery he performed was so wonderful that even the anesthesiologists were in awe of him.
Although they were conducting emergency treatments, there was a relaxed atmosphere in the operating theater that Lu Zewei had not felt for many days.
The anesthetist's excitement could not help but be revealed in his eyes.
Was the internal fixation of a tibial fracture that powerful? Lu Zewei did not understand but remained silent. He waved his hand and stood behind Zheng Ren's body to watch the surgery.
The surgeon took the right tibial node and made a longitudinal incision on the lower edge of the patella. The incision was about five centimeters long. The skin, subcutaneous tissue, and fascia were cut layer by layer. The patella tendon was cut lengthwise and the prepatellar fat pad was pushed open. The patient bent his knee and made a groove about 0.5 centimeters from the medial side of the tibial node.
These were all routine surgical steps. There was nothing to be surprised about.
Although the surgical field was very clean and the operative method was very agile, it was not to the extent that it would make the anesthetist's eyes shine with excitement.
The soft drill was made its mark at 8mm, 9mm, and10 mm. After the proximal end of the fracture was reamed, the anterior and medial sides of the broken end were cut open, and the broken end was reset under direct vision.
The operative view was not bad but if there was anything special about it... Lu Zewei could not see it.
Internal fixation of the tibia fracture. It was a very simple operation. There was no need to do it in the hybrid operating room, right?
Lu Zewei glanced at the surgeom. There was a bruise at the corner of his eye. It was a little strange and embarrassing. However, Su Yun had said that he had suffered a lot when he came down from the frontline. Even so, he could still tell that the surgeon was very young. He was not the old man that he had imagined.
Was he the boss that Su Yun had mentioned? No way. At this age, any random person would be spat to death by Su Yun.
Even if he had skills, how could he be as powerful as Su Yun?
No, it definitely wasn't him.
Lu Zewei thought this to himself as he watched the surgery. The more he thought about it, the more curious he became. Where was Su Yun's boss?
After the reduction, the surgeon pushed the 10mm long, 330mm intramedullary nail into the groove. Under the sight, he locked the two 40mm and 35mm nails at the far end, and the 65mm and 70mm nails at the near end.
"Anesthesiologist, please change the warm saline gauze again," the surgeon said softly after the fracture was fixed.
The anesthesiologist responded crisply and immediately went to change the warm saline water gauze on the patient's foot.
What was the use of doing a hot compress on the foot for a tibia fracture? Lu Zewei was a little confused.
Could this be a new surgical method of the orthopedics department?
The anesthesiologist began to rinse the incision. The scrub nurse counted the gauze and instruments without error before closing the incision before the knee.
There was still nothing amazing happening. Apart from the speed, Lu Zewei could not see what shocked the anesthesiologist.
The more it was like this, the more curious he was.
He firmly believed that the look in the anesthesiologist's eyes could not be fake.
If Su Yun was not present, he would have asked the anesthesiologist. However, with Su Yun around, Lu Zewei did not hesitate and gave up on this option.
Back then, he was still studying for his PhD in Huaxi. His classmates worked like lab dogs for their boss in the laboratory, doing stem cell cultivation. When he had time, he would go for a stroll and play. He had met Su Yun before.
He was handsome and had a high level of skill. He was the sort that women loved.
However, as soon as he came into contact with him, Lu Zewei realized that this guy was simply the most typical arrogant guy who just relied on his talent.
Because he was so talented, he looked down at everyone. His contempt came from the bottom of his heart and was present all the time.
There were all kinds of rude and sarcastic remarks that came from him.
It was good that he did not resist. He just had to call him Brother Yun. Once he resisted, it would attract even more violent 'attacks'.
Anyway, Lu Zewei only saw Su Yun once and ran away.
It was best not to see such a person for the rest of his life.
But after only meeting him once, he always remembered him. Later, he even heard from his classmates that this guy was the one who performed the autologous stem cell cultivation heart transplant surgery on a white mouse.
Lu Zewei's evaluation of Su Yun was that he was a super scholar, a sharp and mean one. A handsome, sharp and mean super scholar.
It was strange. Where was his boss? Why wasn't he here yet? Besides, Su Yun was playing the role of an assistant and scrub nurse. During the entire surgery, he didn't even see him bully anyone.
Was he bullying him because he saw that he had a good temper? Lu Zewei felt a little bitter.
Just as Lu Zewei began to let his imagination run wild, the surgeon had already begun the surgery.
He then extended the fracture-end reduction incision to both sides.
As soon as the operative view changed, Lu Zewei was stunned.
The skin on the patient's calves was dark. At a glance, one could tell that it was the patient who had been under pressure for a long time, causing necrosis.
Recently, there were simply too many similar patients. Lu Zewei had seen a few amputations with his own eyes.
These were patients who were about to have their limbs amputated!
They were about to have their limbs amputated. Why did they need internal fixation? Lu Zewei was stunned.
At this moment, there was no longer any benefit in doing such a thing. The people who could appear in the operating theater were all there to treat patients and save people.
Lu Zewei had also seen surgical errors caused by exhaustion. Because there were other people who would save the scene, there were no harmful consequences.
Was the surgeon tired? Why woul
d he do such a thing?
While Lu Zewei was in a daze, the surgeon had already opened the deep and shallow compartment of the posterior tibial artery. The tension in the compartment was high and the muscles were bruised, colored a dark red. Its elasticity was still good. The clamp was striated as he examined the posterior tibial artery and the soleus muscles. finding that the posterior tibial artery was completely spasming along with the horizontal contusion of the fractured end. There was no pulsation, and the posterior tibial nerve was intact.
After the examination, Su Yun handed over a piece of warm saline gauze and gave it a warm compress.
Su Yun also heaved a sigh of relief when he saw that the posterior tibial nerve was intact in the blood-clotted and dark red wound.
He raised his head and saw Lu Zewei standing behind Zheng Ren. He smiled and said, "Professor Lu, what advice do you have?"
Chapter 731 - Crushing Knowledge
Lu Zewei smiled awkwardly but as Su Yun lowered his head, his expression gradually became serious.
Osteofascial compartment syndrome and decompression? The necrosis was already in its last stages so how could he reduce the pressure?
Although he was not in the orthopedics department, Lu Zewei still understood the most basic of medical problems.
The surgeon took another 20cm long vertical incision on the outer side of the right calf and cut open the skin and subcutaneous tissue.
When he opened the fascia of the lateral and anterolateral compartment, he saw that the tension in the fascia was higher and the muscle had been striated.
The surgeon sighed and began to cut off the necrotic tissue.
"Boss, how much will the motor function be affected?" Su Yun suddenly asked.
"By quite a bit. However, it's still better than complete amputation," Zheng Ren answered. "To be able to save one leg is already considered a relatively light injury. After the surgery, they just need to do more functional exercises so that the other muscles can get used to compensating for some of the other functions."
Lu Zewei was dumbfounded.
It was not because of the whole muscle resection. This kind of surgery was rare but was definitely not unheard of.
He was a little dumbfounded because he heard Su Yun call the young man in front of him 'boss'.
There was such a young boss? And he was also in the orthopedics department. What could he do to make the always noisy and sarcastic Su Yun behave?
The surgeon and Su Yun were talking, but their speed had not even slowed down in the slightest.
He probed the area of the technique and saw that the injury level of the anterior tibial artery on the tibia and fibula fracture had become thinner. The far-side pulsation was obviously weakened. The near-side pulsation was normal, and the superficial peroneal nerve was intact. He gave a warm saline wet compress and then checked the posterior tibial artery. The near-side pulsation on the level of the tibia and fibula fracture had recovered.
Zheng Ren finally let out a long breath he had been holding.
"It's finally open. The embolization time is still relatively short. If it were a few more hours, I'm afraid it wouldn't work."
Su Yun smiled and didn't say anything.
Zheng Ren asked the anesthesiologist to take a look at the foot. The anesthesiologist was also very excited. He quickly walked around Lu Zewei, opened the warm saline gauze, and used his hand to measure the injured person's foot.
"The dorsalis pedis artery is fluctuating!" the anesthesiologist said excitedly.
"Then it's completely opened." Zheng Ren was also very happy. He asked, "Is there any problem with the VSD suction of negative pressure?"
"Yes."
"After the operation, things will be dependent on the situation. If there's a problem with the decompression incision..."
"Boss, you're very long-winded. This is Chengdu Provincial Hospital. You don't have to worry about the most basic operation," Su Yun said as he raised his head to look at Zheng Ren.
The recovery of the arterial fluctuations meant a lot of things. The simplest thing was that the injured person who was carried down could temporarily avoid amputation.
The reason why it was temporary was because there was necrotic tissue in the local area. In addition to the compartment syndrome, it was hard to say whether the muscles, blood vessels, and nerves could survive.
The rest would depend on the subsequent treatment methods. Among them, VSD decompression technology was one of them.
VSD technology, also known as vacuum sealing drainage technology.
Negative pressure was attracted to the cell membrane, making it expand and distort. The damaged cells would then transmit information to the nucleus through signal conversion, causing the cell to secrete pre-healing growth factors, including vascular proliferation factors. This would then stimulate the tissue to produce more new blood vessels.
Moreover, it could effectively reduce the possibility of infection after the operation.
For the patient lying on the operating table, without the VSD decompression equipment, the probability of his calf being saved was less than 10%. However, with the VSD decompression equipment, there was an 80% chance of it going the other way.
"Hehe." Zheng Ren was already immune to Su Yun's words. He just chuckled.
"Boss, speaking of VSD decompression, do you know of any other uses?" Su Yun suddenly asked.
At this moment, all the problems had been solved. Zheng Ren was also very happy, so he smiled and said, "Is there an effect of negative pressure on ED treatment? I think it's quite unreliable. Although there are relevant reports in all kinds of literature, there's not enough data on it so I'm still skeptical."
"You even know this?" Su Yun was surprised.
"When I studied VSD to reduce stress, I read relevant literature reports." Zheng Ren said, "If you want, there will probably be technical improvements soon so there's no rush."
Uh... Lu Zewei saw that Su Yun was defeated and was secretly happy.
Back then, he kept not being able to talk in front of Su Yun. It was not because this guy read all kinds of books. Besides being skilled, he was also quite picky with the topics he chose to talk about.
He could not talk back because his skill was not as good as Su Yun's.
Lu Zewei was secretly happy for a few seconds but when he thought about it, he was stunned.
Facing Su Yun's provocation, the wizard in front of him had easily resolved it. How did he do it? It was because when Su Yun opened his mouth, the surgeon knew what he was going to say next.
This showed his crushing knowledge reserves. Although it was not as direct as having overwhelming skill, but from the side...
This surgeon seemed to be very powerful.
Yes, that seemed to be the case. Lu Zewei was still not very sure.
He looked at the surgeon in a daze as he performed another incision on the back of the foot to reduce the pressure on the injured patient. The surgeon touched the back of the foot artery and said, "The fluctuation is still okay. I want to make an image to take a look."
"Boss, this doesn't seem like your style." Su Yun had just silently suffered a loss. He grabbed Zheng Ren's words and wanted to retort.
"Yes, embolization is a destructive surgery. I'm usually quite confident but when I do a surgery, I always think about seeing the results after opening the capillaries," Zheng Ren said lightly.
Lu Zewei was a little confused. When he saw the surgeon and Su Yun start to brush their hands again, he still did not understand why.
"Old Lu, let's go out and take a look." The anesthesiologist pulled Lu Zewei out of the operating theater.
"What... What kind of surgery is this?" Lu Zewei still hadn't figured it out.
"Old Lu, we've met a master today." The light in the anesthesiologist's eyes was a little dazzling.
"Ah?" Lu Zewei still didn't understand why he was so excited. Seeing that the scrub nurse had also walked out and closed the airtight lead door, he quietly listened to the
anesthesiologist's words.
"Old Lu, this patient was a volunteer who entered the mountain," the anesthesiologist said. "When he was evacuated, he was hit by a rock on his calf, causing a fracture. He was crushed by the rock for more than an hour. Because the follow-up staff arrived in time, the impact injury and necrosis were not too serious."
"But he should have amputated his leg, right?" Lu Zewei was a little puzzled.
"This is what makes it awesome," the anesthesiologist said proudly as if he was the one who performed the surgery. "Just now, when the injured were sent here, Chief Chen sent them up."
"Which Chief Chen?"
"The retired interventional department chief. You haven't seen him before. The old man has a very stubborn temper." The anesthesiologist did not forget to comment on Chief Chen's temper before he continued, "Chief Chen said that these volunteers are here to help us. If possible, they won't amputate. I thought it was just a fruitful wish and I didn't take it seriously. But who would have thought that the surgeon would agree and start the surgery."
"I saw it. Is the fracture fixed?"
"What you saw was the second half," the anesthesiologist said. "The truly amazing part is the first half of the surgery."
Chapter 732 - A Piece Of Cake
"The first half?"
"Interventional surgery, removal of the embolus," the anesthesiologist said. "I've also helped perform interventional surgery with general anesthesia, but I've never seen someone with such a high standard."
Although Lu Zewei was from the cardiosurgery department, he still had some understanding of embolus removal.
Judging from the degree of necrosis of the patient's skin, it was likely that he had passed the acute stage. How could he successfully remove the embolus?
The probability of removing a fresh embolus was much higher than that of removing an old one.
"There's only one surgeon. He's very skilled in operating the guide wire catheter. The removal of the embolus is not vague at all. He can catch the embolus accurately." The anesthetist was practically drooling in worship, unable to be contained by the sterile mask.
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