Doctor’s Life Simulator

The patient's condition is also very complicated. The patient is a male farmer, 46 years old, with impaired consciousness due to a traffic accident, a skin defect on the back of the ankle joint of the foot with Achilles tendon and exposed calcaneus.

When he was first admitted to the hospital, the patient was confused, pale, cold limbs, distressed, and anemic. The entire ankle was irregularly injured, the skin was avulsed, and the bleeding continued.

After further physical examination, it was found that the blood supply of the avulsed skin was poor, the capillary reaction was not obvious, the ankle artery was exposed, fractured, retracted and blocked, the pulse of the dorsal artery was difficult to touch, the peripheral toes had no blood supply, the color was pale, and the skin was warm. Low, flat toes, loss of capillary response...

Analyzing the patient's condition, You Daren and Wu Youtu also looked solemn, but the youngest Qin Lang looked calm.

Before the operation, the flap had been designed, and Doppler ultrasound detection and marking were performed on the vascular path.

"Doctor You, Dr. Wu, let's get started."

After Qin Lang spoke very calmly, he began to devote his full attention to the operation.

On the contrary, You Daren and Wu Youtu were slightly nervous and stared at Qin Lang intently.

Since the flap design plan had been determined before the operation, Qin Lang quickly started the first step, incision!

With the perfect incision technique, Qin Lang found the design point very accurately. The axis line of the flap was the line connecting the tuberosity of the navicular bone to the medial midpoint of the first metatarsal head. Anteriorly to the second metatarsal head, posteriorly to below the anterior border of the medial malleolus, dorsally to the midpoint of the anterior border of the medial malleolus and the medial border of the toes (mother of the foot).

Looking at Qin Lang's operation, You Daren was slightly startled: "This little doctor Qin's hand strength is well controlled and stable, especially his knife-handling skills."

Wu Youtu on the side was not too surprised. After all, he had been an assistant with Qin Lang several times.

Soon, Qin Lang neatly completed the incision of the entire flap, and the incision area was very precisely controlled at 11cmX9CM.

You Daren's eyes lit up: "This is basically the maximum incision area in theory. This little guy really dares to make an incision! I admire it."

With Qin Lang's operation, You Daren has changed his mentality, and even in Qin Lang's operation, he still has some insights and gains.

Wu Youtu on the side watched quietly, but felt that Qin Lang's cutting technique was as perfect as ever.

As for what extreme operation, what is Mi Dongdong?

After all, there is a specialty in surgery, and Wu Youtu is not very good at free flap transplantation, and he is not as obsessed and meticulous as You Daren is in surgical skills. As for these theoretical limit data, it is not so sensitive.

Next, Qin Lang continued to make an incision on the northern edge of the flap. With the dancing of his knife tip, he avoided the arterial variation very accurately and dissected it meticulously.

Looking at Qin Lang's operation, You Daren once again marveled: "Using the larger cutaneous artery and vein as the vascular pedicle, and adjusting the flap incision line at any time according to its running direction, this kid really has aura!"

"Doctor Xiao Qin, did you really just start learning free flap transplantation?"

You Daren continued to watch Qin Lang's operations in disbelief, while Wu Youtu, who was beside him, watched Dr. You's reaction from time to time, speculating on Qin Lang's level.

"It seems that this kid Xiao Qin is still getting started very quickly. Doctor You, who is so picky, can't find any obvious mistakes. Ruzi can be taught."

Then, seeing Qin Lang starting to move backwards, You Daren's eyes lit up:

"The width of the pedicle fascia is just controlled at 2cm, this kid is really confident."

Generally according to his habit, at this time, in order to prevent the cut too small, it will always exceed the theoretical value, plus the human error, often around 2.2cm.

"Hey, what is this kid doing?"

Wu Youtu couldn't understand Qin Lang's operation next.

Wu Youtu looked at You Daren, who was also puzzled and didn't understand.

"Qin Lang, what are you doing?"

Qin Lang continued the operation and explained: "In order to avoid the wound opening due to postoperative swelling, it is necessary to thoroughly excise the scar tissue with poor blood supply and inelasticity in the recipient area..."

Hearing Qin Lang's explanation, You Daren was stunned: "That said, your operation is too meticulous. Under normal circumstances, who can achieve absolute debridement and remove scar tissue. Repeat rinsing as a rule of thumb, making sure not to place sutures on the edematous granulation tissue and crisp scar tissue."

After all, very few people can control the strength and angle of the scalpel so finely. It is too much. In order to absolutely debride the wound, the rest of the tissues and blood vessels and nerves are injured, which is not worth the gain.

However, the next moment, You Daren saw the power of Qin Lang's micro-manipulation!

There was a roar in You Daren's mind, as if he had subverted his previous surgical guidelines. He has always tried to be safe, so many operations are very rough and not precise.

For example, for simple sutures, he only wants to be able to heal later, without opening the thread or splitting, and he does not go back to consider the issue of aesthetics at all. Even if a scar grows, it is just not good-looking.

However, this time Qin Lang's operation showed him another possibility, that is, the fineness of art. In addition to practicality, it also takes into account the aesthetics of postoperative healing and the slightness of scars.

For another example, in the vascular pedicle, when choosing to retain the triangular skin, according to his clinical thinking, he will choose to appropriately relax the width of the pedicle to prevent the vascular pedicle from being compressed and ensure safety.

But in Qin Lang's operation, he saw the limit of control. Each of his cuts was taken at the theoretical best position, and the same was true for subsequent stitches. It's the same, neat and tidy.

"It turns out that surgery can be done like this."

Of course, if you want to do this, you must control your strength and angle to the extreme, as well as be familiar with theoretical values. Every step of the operation requires full attention and care.

The last operation of his own operation flashed through You Daren's mind. At this moment, following Qin Lang's extreme operation method, You Daren saw many flaws.

"The flap design line can be more precise, the incision area can be more precise, and the flap can be separated deeper..."

"I see!"

You Daren was suddenly enlightened. It turned out that the free flap transplantation was okay, so meticulous!

[Ding, because of your extreme operation display, You Daren was like a titular dick, and began to push it again, reconstructing his surgical thinking, and he broke through the bottleneck. 】

Qin Lang, who was doing the operation on the side, had also come to the end. Hearing this voice, his face became happy~www.wuxiahere.com~ and then waited, another breakthrough of Wu Youtu.

Time passed by, and the sound of the system has not been heard for a long time.

Finally, the whole operation was completed perfectly.

You Daren was still in the mood and began to look forward to the next surgery. He couldn't help but ask, "Qin Lang, this is really the first free flap transplant you performed? How did you learn so many detailed techniques?"

Qin Lang said without blushing: "Thanks to the classic case videos that Dr. Wu found me before, I watched it many times yesterday, plus Dr. You's actual combat operations before, let me I got the hang of it, and I started the operation very quickly."

"Maybe, I have a little talent."

Wu Youtu nodded: "Xiao Qin is indeed very talented in clinical practice. Of course, he also has the influence of classic case videos and Dr. You's hands-on guidance. Dr. You, give Xiao Qin a comment on how the operation was completed? I see. After that, there are no obvious mistakes and omissions, and the completion is still very good.”

You Daren and Qin Lang both revealed a look of contempt in their eyes:

"Do you really think that free flap surgery can be done with hands?"

[Ding, because your detailed operation and surgical thinking are beyond Dr. Wu's understanding level. He just thinks your work is okay. Also, I think thanks to his instructional videos for giving you ideas, I think the difficulty of free flap transplantation is overstated. Or continue to delve into his own field. Because Dr. Wu did not realize the breakthrough. mission failed. 】

Qin Lang's mouth twitched.

"Qin Lang, don't worry about Dr. Wu, we will continue with the second operation."

You Daren also glanced at Wu Youtu with disgust, then looked at Qin Lang with fiery eyes, and said expectantly.