"My son, don't kill the cow. We rely on those animals for farming..." The old man lying on the operating bed began to talk nonsense. Although he was injured by the cow, he still couldn't forget it.
"Lei Zi, hurry up, the old man is delirious." Chen Dayong urged.
While ensuring the accuracy of the drug dosage, Zhang Lei increased the speed as much as possible and quickly completed general anesthesia.
Lin Xiaomei was already counting the instruments and gauze with the circulating nurse.
Li Zheng also washed his hands and started to put on surgical gown.
Chen Dayong uncovered the steel basin covering the old man's abdomen, and the color of the intestines became darker.
Zhu Haiping has also washed his hands, quickly disinfected them, and laid out a sterile sheet.
Li Zheng stood to the right side of the patient.
"Adjust the lights." Li Zheng said.
The circulating nurse immediately took a step stool and adjusted the shadowless light to face the abdominal wound.
Li Zheng stretched out his hand.
Lin Xiaomei immediately slapped the skin-cutting knife on his palm.
Without any hesitation, Li Zheng cut the skin diagonally along the side of the wound.
Then separate the subcutaneous tissue and bluntly separate the internal oblique muscle to reach the peritoneum.
Chen Dayong also put on his surgical gown and stood opposite Li Zheng.
Prepare the suction device.
Chen Dayong quickly aimed the suction tube at the peritoneum.
Li Zheng cut it open with one knife.
A stream of yellow feces gushed out, accompanied by a foul odor.
Chen Dayong quickly took a deep breath.
"vomit."
Zhu Haiping suddenly retched.
"Haiping, you still need to adapt more!" Chen Dayong said in a deep voice.
Zhu Haiping closed his eyes and quickly stabilized his churning internal organs.
After a few seconds, I opened my eyes and the situation was much better.
"Prepare warm saline solution," Li Zheng said. He continued to open the abdominal cavity.
The circulating nurse immediately pried open the bottle of warm saline solution, which had been prepared long ago.
Pour warm salt water into the steel basin.
Lin Xiaomei handed it to Li Zheng.
Li Zheng poured warm saline into the abdominal cavity and flushed it repeatedly.
A large amount of feces and some mud and sand were washed out.
It took 6 bottles of warm saline to completely flush the abdominal cavity.
Next, the bowel is explored.
"There are quite a lot of damaged segments!"
A voice suddenly came from behind him, and Chen Dayong turned around to look.
"Guo Weiqiang, are you walking silently? I was scared by you." Chen Dayong glared at him.
Guo Weiqiang chuckled and said, "I'm just afraid of disturbing your surgery!"
Chen Dayong snorted, ignored him, and concentrated on the operation.
"Both the colon and ileum are damaged, with multiple perforations, and part of the ileum is black and gangrenous." Li Zheng concluded after the examination.
"The black and necrotic parts must be cut off, and the length of the ileum will be much shorter. This old man's physical condition will definitely be much worse in the future, and it will be impossible for him to do farm work." Guo Weiqiang shook his head, feeling sorry for the old man.
"Wouldn't it be better not to do farm work? At my age, I should just enjoy my retirement," said Chen Dayong.
Guo Weiqiang shook his head and said, "If I do some farm work, I can still make some food for myself. If I don't do farm work, my family will dislike me and my life will be difficult in the future."
Zhu Haiping couldn't stand it any longer and retorted directly: "Not all children are unfilial. I think the old man's family is very good. Even if the old man can no longer work, they will take good care of him!"
"That makes sense! Xiao Guo, don't look at everyone with your narrow vision!" Zhang Lei, sitting on a small round stool, echoed.
Guo Weiqiang was speechless. He glared at Zhang Lei and said, "You're even younger than me, and you still call me Xiao Guo. You should call me Brother Qiang!"
Zhang Lei crossed his legs and laughed, "I can't call you Brother Qiang, calling you Xiao Qiang is more appropriate."
"I don't want to bother with you, little fat guy!" Guo Weiqiang muttered.
Zhang Lei didn't care and said with a smile: "Okay, from now on you call me Little Fatty and I'll call you Xiao Qiang, that's it!"
Guo Weiqiang didn't argue with Zhang Lei and watched the operation carefully.
"Add some warm saline gauze." Li Zheng said.
Lin Xiaomei immediately prepared to hand it to him.
Li Zheng applied gauze to the blackened intestinal tube and began to treat the wound on his back.
"Brother Zheng, what are you doing?" Guo Weiqiang asked curiously.
Li Zheng said in a deep voice: "The black and blue intestinal tract is not necessarily necrotic. Part of the intestinal tract is affected by blood circulation. Applying hot compress can better distinguish it."
Guo Weiqiang nodded and quickly memorized it.
"Brother Zheng, you pay great attention to details." Guo Weiqiang praised.
Li Zheng continued to pull open the intestine and found that the wound on the back was very close to the abdominal aorta.
Chen Dayong said with lingering fear: "If the horn had moved inward another centimeter, the abdominal aorta would have ruptured and the old man would have died on the spot."
"Well, he was lucky. The plowing cow didn't hurt him any further. The old man was lucky enough to survive." Li Zheng said.
After hearing what Li Zheng said, everyone was not so worried anymore. It meant that not only would the operation be successful, but the recovery after the operation should not be a big problem either.
Using an abdominal retractor to pull open the intestines and blood vessels, Li Zheng began to repair the wound on his back.
Place the patient on his side and perform thorough debridement after disinfection.
The inside and outside are sutured layer by layer.
After finishing the treatment, the old man was asked to lie down flat.
Li Zheng uncovered the warm saline gauze.
Several people quickly leaned over to look.
"Hey, a part of it has really turned red, and there is a slight pulsation in the mesenteric artery!" Chen Dayong shouted.
Guo Weiqiang couldn't see it, so he asked anxiously, "Has the intestine turned red? How large is the area?"
Li Zheng checked himself and nodded, "Compared to before, about one-third of the intestine has turned red."
"That's much better. Although the small intestine is five or six meters long, it's best to preserve it as much as possible." Guo Weiqiang said seriously.
Next, Li Zheng cut out the obviously necrotic intestine and began to suture it.
First, perform full-thickness interrupted sutures, and then use absorbable sutures to perform continuous sutures on the seromuscular layer of the intestinal tube.
"Hey, Brother Zheng, your suturing method is very special!" Guo Weiqiang asked in surprise. He had never seen this method before.
Li Zheng nodded and said, "This layered suture can make the intestinal tract more tightly aligned and reduce the occurrence of anastomotic leakage, but the operation is relatively complicated and time-consuming."
Guo Weiqiang was a little speechless and said with a wry smile, "Brother Zheng, it didn't take you that long to sew it up! It's faster than our Director Wang's continuous overlock stitching!"
Chen Dayong chuckled and said, "That's Brother Zheng. If it were you, or Director Wang, Brother Zheng's words would come to light."
Guo Weiqiang nodded. It was true that Li Zheng’s standards could not be used to measure him. He was different and could not be compared.
Chen Dayong carefully fixed the broken end with intestinal forceps, and the two cooperated tacitly.
The stitching speed is getting faster and faster.
For some intestinal tracts that are only partially damaged, Li Zheng repairs them using end-to-side or side-to-side anastomosis, so as to preserve as much undamaged intestinal tract as possible.
After sewing each anastomosis, Li Zheng gently separated the mesenteric fat near the rupture, covered the anastomosis with it, and then fixed it with fine catgut.
"Brother Zheng, you pay attention to details everywhere! Covering the intestinal wound with the mesentery is like covering the wound with a quilt, which can enhance the healing ability!" Guo Weiqiang couldn't help but sigh that high-level doctors are often better at handling details.
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