Chinese medicine: When you do things to the extreme

Chapter 135 Second round of preliminary selection (subscription required)

The next day, when Zhou Yanqing came to the Hand Surgery Department again, there were exactly fifteen people waiting.

Zhou Yanqing, a young man under 30 years old, stands out from the crowd.

Moreover, Zhou Yanqing was placed first!

Starting from the second person, they are basically young people over 30 years old.

This time, the person who came to receive them was no longer a doctor or a master's degree holder, but Dr. Ou Kai from our hospital. He began to call out the names: "Zhou Yanqing."

Zhou Yanqing raised his hand.

Ou Kai had a very deep memory of Zhou Yanqing. After all, he was the one who made Professor Xiao suddenly observe seriously yesterday. Zhou Yanqing's suture operation also made Ou Kai feel unbelievable.

Of course, when Zhou Yanqing raised his hand, others also looked over and tried very hard to recognize Zhou Yanqing.

But except for one person, no one else could retrieve any memory related to Zhou Yanqing, as if Zhou Yanqing had suddenly appeared.

"Miao Zhixiong." Ou Kai continued to call out the names.

Zhou Yanqing also looked at the people in the crowd, trying his best to remember their names.

There is a certain threshold for people who sign up for private training classes. They are basically top doctors from famous hospitals and are already employed doctors. Their presence is enough to make Zhou Yanqing pay special attention to them.

The specialty ranking of hand surgery is not completely consistent with the ranking of the hospital's comprehensive strength.

"..."

"Brothers are welcome to continue to participate in the second round of our college's primary election."

"But the number of places in the private class is limited, because the number of people we are opening this time is limited to five, so I hope that you brothers can continue to demonstrate your strengths."

"Today's assessment is relatively simple. It is the replantation of rabbit's severed limbs."

"The assessment time is also synchronized."

"We should be able to finish the second round of assessment in one morning, and finally grade everyone based on their comprehensive performance." After Ou Kai explained the simple assessment process in a formatted manner, he led everyone to the intermediate training room they had arrived at yesterday.

After arriving at the door of the training room, Ou Kaicai continued, "For this round of assessment, the top six will have two people per training room, and the bottom nine will have three people per training room."

"This arrangement will allow all of you to take the exam at the same time, making the assessment more fair."

"Please forgive the limited resources in our training room." After Ou Kai said this, he looked at the time.

"The current time is 8:30, and the operation is expected to be completed around 1:00 p.m. Brothers who have not completed the operation by 1:00 p.m. should not force themselves to continue."

No one has an opinion.

Private tutoring classes are essentially a "transaction" between two willing parties.

You can choose not to come, or even leave at any time, and no one will force you.

As for the so-called absolute fairness, that certainly does not exist. The applicants are not everyone, but only those who meet certain conditions.

Zhou Yanqing and Miao Zhixiong walked into the first training room, where there were two operating tables placed horizontally on the left and right.

On the operating table, the rabbit had been anesthetized and fixed on the table with its limbs stretched out, and its limbs had been severed, with the stumps simply bandaged.

This truly simulates the clinical patient admission situation.

When patients with short limbs are encountered in clinical practice, they will be sent to the emergency department after simple bandaging and then to the operating room.

In the training room, the scene of going from the emergency department to the operating room is avoided.

What remains now is the operation of Zhou Yanqing and others.

"Doctor Zhou, Doctor Miao, each of you will be assigned an assistant. They will unconditionally follow your instructions and help you complete the operation."

"We supervise the whole process. If the operation fails or an accident is caused by their operational errors, we will not deduct points at our discretion." This was the discipline announcement by another unknown staff member.

There were also two other people, either masters or doctors, who were fully armed and standing diagonally opposite the operating table, with their arms folded across their chests, in a completely sterile state.

After Zhou Yanqing and Miao Zhixiong both nodded, the staff member announced: "The assessment can begin. Doctor Zhou, Doctor Miao, please start the operation."

Even in the case of limb replantation, the stump must be disinfected and flushed first.

However, both Zhou Yanqing and Miao Zhixiong carefully checked whether the rabbit-specific tourniquet on the affected limb was in place.

Zhou Yanqing also specifically checked the rabbit's anesthesia status.

After finding no problems, Zhou Yanqing put on a pair of examination gloves and instructed another person who played the role of a "patrol" staff member to open the tourniquet before untying the bandage and flushing the stump.

During the flushing process, Zhou Yanqing also discovered that the staff here were very professional when making the severed limbs, and that there were foreign objects such as pebbles mixed in them.

These are all issues that need to be addressed during the debridement process.

The process of debridement is also a process of observing the surgical field.

After Zhou Yanqing finished rinsing, he looked at Miao Zhixiong opposite him and found that the other party had more experience than him, so he had already laid the towel.

But Zhou Yanqing was not in a hurry.

For time-limited surgery, speed and quality must all be guaranteed.

Zhou Yanqing also quoted a sentence from Ou Kai.

If the operation is not completed by 1:00 p.m., there is no need to continue. This time-limited operation is definitely not a casual statement.

This means that the eight-hour operating limit is at 1 p.m., which means that the short limb has already existed for about four hours.

At this point in time, restoring blood supply is the first option for replanting a severed limb.

The order of suturing will change later.

Zhou Yanqing also disinfected the drape with another assistant. After everything was standardized, Zhou Yanqing began to put on clothes and sterile gloves, and then started the debridement operation without stopping.

While Zhou Yanqing was cleaning the wound, Miao Zhixiong next door had almost finished the cleaning.

The staff had prepared the skin in advance. This is a domestic rabbit, and domestic rabbits have hair. If Zhou Yanqing had to prepare the skin before the operation, it would obviously slow down the process.

Zhou Yanqing also began to clean the wound carefully, and politely invited the assistant opposite to clean his field of vision.

The other party is an assistant, not an examiner, and it is reasonable and legal to let the assistant complete some operations.

In any operation, assistants will take on certain tasks, and this is definitely not a violation.

However, Zhou Yanqing's order made the "assistant" on the other side feel a little surprised. However, he paused for only two seconds and then started to clean the wound with tweezers.

After he finished cleaning the wound, Zhou Yanqing checked him and found that the other party's strength was also very good.

It won’t be worse than it was six months ago.

He should be of a certain level, perhaps even a young doctor in our hospital, not an ordinary doctor...

Then, Zhou Yanqing came to his home court and asked the other party to help pull the skin and fix the affected limb.

The key point of limb replantation is still to fix the bones first, and open reduction and plate screw internal fixation of the fracture should be performed. If the bones are not fixed, the so-called limb replantation is a joke.

At this step, Zhou Yanqing still lags behind Miao Zhixiong next door.

However, after their blood vessels were sutured, their progress became equal.

In the following tendon suture operation, Zhou Yanqing was three minutes ahead of Miao Zhixiong and completed all the operations.

Zhou Yanqing then checked it again before starting the nerve suturing operation.

Zhou Yanqing was very decisive in shortening the nerve stump and trimming the epineurium to decompress it, without any delay.

After the nerve end was exposed and no necrotic nerve tissue was found, Zhou Yanqing sutured the prepared epineurium 'device' with the rabbit's epineurium.

The severed large nerve did not have a surgical membrane, so it was not suitable for combined suturing of the surgical membrane and the outer membrane.

Zhou Yanqing sutured very quickly and did not hesitate after inserting the needle.

On the contrary, the other party's 'assistant' was a little surprised by Zhou Yanqing's operation speed, and reminded him at the right time: "Don't be in a hurry, quality is the most important."

Zhou Yanqing did not answer. The pace and quality of the operation were controlled by the surgeon. Zhou Yanqing was confident that he could manage the entire process of the operation.

At present, Zhou Yanqing believes that he may be slightly better than his brothers in expert-level limb replantation surgery.

Zhou Yanqing's speed did not slow down, but the details of the operation became more and more.

Just like the severed nerves and blood vessels, there are more than one severed nerve.

For the suture of another nerve, Zhou Yanqing chose to suture the perineurium and epineurium together.

After this, the nerve suture comes to an end.

However, Zhou Yanqing was not in a hurry. Instead, he asked the "patrolling" staff to temporarily loosen the tourniquet and began to check the blood circulation of the stump.

A small vein was punctured at the distal end of the rabbit's hind leg.

After discovering blood slowly seeping out, Zhou Yanqing determined that the blood circulation must be good.

The reason why we don’t take blood from the fingertips is that the stratum corneum of rabbits’ feet is thicker than that of humans. It is better to do a precise venipuncture.

After making sure that the blood circulation was good, Zhou Yanqing gently pressed the needle hole on the vein while continuing to wait for the tourniquet to rest.

At this time, Zhou Yanqing discovered that the opponent's Miao Zhixiong was also waiting for the tourniquet to stop.

However, he looked at Zhou Yanqing very nervously.

Clearly, he started the operation earlier than Zhou Yanqing, but Zhou Yanqing was almost finished with the operation while his blood vessel suture had not yet been completed.

In other words, Zhou Yanqing could finish the operation before 11 o'clock, but it might take him until after 12 o'clock.

If Zhou Yanqing hadn't been messing around, his technical level might have been a level higher than his!

But how is this possible?
Replantation of severed limbs is a mature surgical procedure, not a basic skill. How many limb replantations has Zhou Yanqing performed?
Which hospital would give Zhou Yanqing so many limb replantations to allow him to accumulate surgical capacity?
Many doubts and unknowns are swirling in my heart.

However, Zhou Yanqing did not read his puzzled look at all, nor did he give a reply. After a slight smile, Zhou Yanqing began to look at his operating field again.

Very refreshing.

There is some blood seeping out from the proximal and distal surfaces of the stump, which means that the blood supply is very good.

Looking at Miao Zhixiong, he had not yet completed the vascular suture, so some of his blood vessels were still clamped closed with vascular clamps.

When blood vessels are blocked, it is difficult to see the blood flow clearly.

Therefore, Miao Zhixiong could not be completely sure of the quality of his surgery.

Zhou Yanqing's operating table was not far from him. He could clearly see Zhou Yanqing's operating table. From the remnants of the surgical field, he could also see that Zhou Yanqing's surgical quality was quite good.

This made Miao Zhixiong's Taoism heart collapse a little.

Zhou Yanqing's operation is faster and the quality is better.

Where the hell did this freak come from?

Huashan? The Third Hospital?

Jishuitan?
West China? Kyoto Union Medical College or Central China Union Medical College?
The Sixth Hospital of Magic City...

Many questions were floating in his mind.

Of course, no matter how unstable the world is, time still moves forward at a constant speed.

Fifteen minutes passed in a flash.

The tourniquet's timer alarm rang, and the "patrolling" assistant took the initiative to ask Zhou Yanqing and others to lift the affected limb, and then started to put on the tourniquet again.

During this time, Zhou Yanqing looked at the remaining ends of the nerve sutures, and then began to suture the skin.

This time the severed limb was relatively smooth and the stump of skin did not require any special trimming.

Zhou Yanqing subconsciously looked at the other party's assistant again, as if he was treating him as Xiao Tianchao.

The assistant's eyes froze a little, and he whispered, "You need to sew this."

He could really understand the look in Zhou Yanqing's eyes. This was the look a superior gave his subordinate.

This made the "assistant" even more certain that Zhou Yanqing must have performed surgeries before and had given his subordinates many opportunities to operate. Otherwise, his eyes would definitely not have been as pure as they were just now.

Zhou Yanqing was not polite and just sutured it, just as if it was an accumulation of suture times.

Zhou Yanqing has been very skilled in skin suturing many years ago. Now, as his basic suturing skills have almost reached expert level, Zhou Yanqing's suturing skills have become more and more perfect.

It certainly cannot be said to be close to perfection, but at least people all over the country and even the world would think that Zhou Yanqing's suturing skills are impressive.

At 11:20, Zhou Yanqing finally completed all the operations with great difficulty.

I looked at Miao Zhixiong next door who was still dealing with his nerves.

After tidying up the equipment table, Zhou Yanqing took two steps back, then bowed gently to the examiners, and then began to take off his gloves and undress, and threw them into the medical waste bin in the practice room.

Zhou Yanqing did not speak, and neither did the examiners. They just signaled the assistant to take the bandaged rabbit out of the cage and restore it to its physiological state.

The rabbit was still lying limply on the operating table, motionless, having not yet woken up from the anesthesia.

Zhou Yanqing, under the guidance of the staff, left the operation room of the training room.

When they reached the corridor outside the training room, the staff member who served as the 'assistant' said cautiously, "You finished too early. You don't have to rush."

"Thank you for the reminder, teacher! There is no such thing as a re-examination for this kind of exam."

“When you do your best, it’s determined at that moment,” Zhou Yanqing explained confidently.

The young man hesitated for a second, but finally said, "I hope you're not in a hurry to leave Kyoto, Dr. Zhou. I may have something to ask you this afternoon."

(End of this chapter)