My Medical Skills Give Me Experience Points

Chapter 1041: Chapter 410: Training Newcomers, Principles of Debridement for Gangrene_2

This kind of performance can only be exhibited by someone with significant strength.

No wonder Director Feng has such affection for this young doctor!

"Hurry up and clean the patient’s wound! We still don’t know what’s inside. Judging by the depth, it might have reached the bone."

Dr. Xu had a serious expression.

Accepting this patient was mostly due to Zhou Can.

Of course, Dr. Xu also felt a sense of compassion.

Doctors with some medical ethics hold a universal belief.

It’s like treating everyone as close relatives, which is not something many doctors can achieve.

Zhou Can currently possesses a level five Wound Cleaning Skill, which is one of the main reasons he’s daring enough to take on this case of gangrene debridement.

With the right skills, he dares to tackle difficult tasks.

Having just a benevolent heart as a doctor is far from enough without the competence.

"Dr. Luo, first help cut off all those sutures for the patient!"

Zhou Can appropriately gave Luo Shishen some training opportunities.

Performing surgery on a gangrene patient is a significant test of a doctor’s psychological resilience. Some people even tend to vomit during the procedure.

The surgical mask does little to block the nauseating stench.

Combined with the visual impact, it’s very easy to feel a churn in your stomach, leading to vomiting.

Some novice doctors, when they see a dead person for the first time, see a bloody scene for the first time, or encounter something disgusting for the first time, may experience severe psychological discomfort. They might be unable to eat for a couple of days.

Zhou Can, having followed numerous chief physicians in surgeries, has gained extensive experience in general surgery, cardiothoracic surgery, and the Emergency Department, and has developed a strong psychological resilience.

Arguably, the most testing environment for psychological resilience isn’t the operating room but the intensive care unit in the Intensive Care Medicine Department.

There are patients there, burn patients for instance, with bodies covered in burns.

They may even present symptoms like body surface eschar melting and suppuration.

Seeing it can indeed make one’s scalp tingle.

Let’s mention that eschar melting not only brings immense pain to patients but is also extremely dangerous.

Especially with extensive eschar melting, prompt measures must be taken to prevent it.

"I..."

Luo Shishen frowned tightly, wearing gloves and holding the scissors that Qiao Yu handed to him, as if being forced into a fire pit.

"Hurry up, stop dawdling!"

Zhou Can urged impatiently.

Since Luo Shishen is now under his supervision, any issues are his responsibility to push forward.

Dr. Xu wouldn’t bother with such matters at all.

Having worked as a nurse in the intensive care unit, Qiao Yu had strong psychological resilience, and since she only needed to pass instruments, she was calm and composed. Ma Xiaolan seemed somewhat unable to endure the disgusting scene, standing by without even daring to look at the patient’s wound.

The operating room conditions themselves weren’t good either.

If it were a laminar flow operating room, even a ten-thousand-class one, it could absorb and vent the foul smell around the operating table.

Now, everyone had to endure the overwhelming stench.

"There are just so many sutures! Isn’t this torture!" Luo Shishen’s hands trembled, and if he hadn’t been wearing a mask, his expression of disgust would have been obvious.

"Concentrate."

Zhou Can instructed again.

In such situations, it’s essential for a senior doctor to be strict.

Under his intimidation, it could help Luo Shishen offset some of the discomfort he felt inside.

The removal of sutures generally involves cutting each knot once.

If dealing with a continuous suture method, only one cut might be needed during removal, but usually, nurses would cut each segment of the suture once.

Because when pulling the suture out from under the skin, it can be less laborious.

Under the pressure from Zhou Can, Luo Shishen cut and removed the sutures segment by segment.

Without the restraint from the sutures, the patient’s wound gaped open further.

Pus mixed with blood dripped down like drool.

The putrid smell became even more intense and pungent.

"Xiaolan, don’t just stand there. Get a trash bin to catch this."

Zhou Can was deliberately training the newbies in the surgical team.

Normally, the circulating nurse might have more experience than the surgeon and wouldn’t need any instructions.

Ma Xiaolan approached with a trash bin, turning her head away and seemingly holding her breath.

"Watch it, don’t let it spill onto the floor. Otherwise, it’ll be a hassle to clean."

Inside the pus are countless bacteria, possibly even viruses.

Washing and disinfecting is no easy task.

"Ugh..."

Ma Xiaolan began to retch, covering her mouth and rushing towards a lidded trash bin.

Dr. Xu watched and shook his head repeatedly.

But he said nothing.

After all, everyone starts as a novice.

Some emotions might indeed be contagious. For instance, yawning—when we see someone yawn, we often find ourselves compelled to yawn as well.

At this moment, Ma Xiaolan’s vomiting seemed to have affected Luo Shishen.

A grown man also joined in the retching.

"With this level of psychological resilience, thorough training is definitely needed."

To not delay the surgical process, Zhou Can personally removed the sutures. Though it was a small task, overcoming inner fears and discomfort wasn’t very difficult.

Soon, he had all the sutures removed.

"Hand me the suction, let me clean out the blood and pus inside."

Zhou Can said to Qiao Yu.

"Here you go!"

Qiao Yu, having prepared in advance, promptly passed it to him.

In principle, removing blood and pus would be an assistant’s job.

However, Zhou Can accommodated Luo Shishen’s discomfort, choosing to handle it himself.

"Let me do it!"

Dr. Xu, having seen many situations as a mentor, maintained a calm demeanor and assisted Zhou Can.

Luo Shishen and Ma Xiaolan, after vomiting, appeared quite embarrassed.

Ma Xiaolan even teared up.

Vomiting can indeed be distressing.

"You two just watch from the side. You need to learn how to adapt and adjust. Following me in surgeries, you’ll undoubtedly face even more trying scenarios in the future."

Zhou Can instructed the two of them.

The patient, on the other hand, looked embarrassed and simply closed his eyes.

In retrospect, it might have been better to administer general anesthesia to the patient.

After cleaning out the accumulated blood and pus, Zhou Can prepared to debride the patient. Many areas of flesh were already completely rotten.

"Xiao Zhou, let’s hear your debridement plan."

Dr. Xu implied that Zhou Can shouldn’t rush to make incisions.

"The patient’s gangrene is a case of wet gangrene. The wound varies in depth, so I plan to debride gradually and in stages. Today, I’ll focus on promptly cleaning the clearly necrotic tissues, while temporarily retaining those with unclear boundaries and uncertain viability."

Zhou Can presented his surgical plan.

Many surgeons mistakenly believe that when debriding a gangrenous patient, they should cut decisively, cleaning the boundary tissues as much as possible. They even remove some normal tissue.

This line of thinking is incorrect.

Doing so might actually worsen the patient’s condition.

For wet gangrene debridement, one should, like Zhou Can suggested, strive to preserve as much healthy tissue as possible. Rushing is inadvisable.

There’s an old saying: hasty work spoils everything, which holds true in surgery as well.

Some might think that by removing all rotten tissue at once, even parts of normal tissue, the wound will be kept clean, and the patient will recover.

Such notions are mere wishful thinking of novice doctors.

Experienced surgeons would undoubtedly follow Zhou Can’s approach.

"Your plan is excellent. Go ahead and start cleaning!"

Dr. Xu, after hearing Zhou Can’s plan, not only appreciated him more but also trusted him to proceed with the operation.

Zhou Can first cleared out the obviously necrotic tissues.

Then, after a preliminary wash of the wound, he carefully differentiated and identified which areas to preserve and which to remove.

This process is much more challenging than it sounds.

It tests the involved doctor’s patience and meticulousness, and requires some skill with the scalpel. Some parts were directly cut off with scissors.

...

After more than three hours, Zhou Can looked at the patient’s wound with a satisfied expression.

The wound, once filled with pus, was now revitalized and looked brand new.

Bleeding had been stopped where necessary.

The visible pus and rotten flesh were mostly gone.