It took him a long time to remember what knowledge point she was talking about. Fortunately, he was also an excellent student and was considered smart. He knew to run behind Xie and ask, "What do you mean by what you said?"
As he asked this, his face turned a little red. He must have remembered the time when he laughed at Geng Lingfei, saying that he was an idiot for following classmate Xie. Now he is the idiot.
"The chest was not closed at the end of the operation." Xie Wanying is a humble person. She would not act aloof and ignore her classmates. She would answer within the time frame she has.
At this moment, Dai Nanhui was suddenly moved.
The two ran to the next ward.
Xiaohui was lying on the snow-white bed sheets, her little face was as white as snow, there was a tracheal tube connected to a ventilator in her throat, and other parts of her body were connected to other machines and tubes. She was like a broken doll, whose life was only supported by machines. It was heartbreaking to watch.
Xie Wanying carefully lifted the child's quilt, revealing the child's chest.
Looking at the transparent dressing on the child's chest, Dai Nanhui finally remembered the relevant knowledge: "The sternum is not closed."
Delayed chest closure, as Xie said, at the end of the operation, the surgeon did not follow the routine surgical procedure to close the patient's chest. The most important step in closing the chest is closing the sternum.
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Why don't doctors close the sternum?
Most of the time doctors do not close the chest because they find that they cannot close the chest cavity after surgery.
So weird? You can't pull up your sternum? You can pull up your sternum with a deadlift, right?
To be precise, if the chest is closed, the patient's life will be gone, so it cannot be closed. This situation is specifically reflected in the fact that after closing the sternum, the heart may be compressed and cause cardiac crisis. There may be continuous bleeding in the heart's large blood vessels, and the chest may need to be opened with gauze to compress and stop bleeding. How to close it? There may be pericardial tamponade, which requires opening the chest for drainage, but it cannot be closed.
What are the benefits of not closing the median sternotomy and opening the sternum? It can expand the volume of the patient's mediastinum, reduce the pressure on the heart, mainly the external pressure on the ventricular wall, and increase the volume at the end of the heart's diastole, all of which are conducive to stabilizing the patient's blood circulation and breathing.
Delayed chest closure does not mean that the patient's sternum will not be closed. It just means that the sternum will be closed after the patient's critical condition has passed.
What should be done if the sternum is not closed and the heart is exposed? The doctor may sew up the outer skin. In view of the critical situation that the patient may need rescue at any time, many doctors now choose to only cover the wound with a layer of sterile transparent surgical film for protection.
If you look closely, through the transparent film, you can see that the unclosed sternum is being held open by a sternum spreader.
What should I do in this situation? Should I perform chest compressions and defibrillation? Dai Nanhui's mind turned to this, and suddenly he saw Xie Wanying in front of him taking action. He became worried and shouted, "What do you want to do?"
Xie Wanying's eyes were fixed on the ECG data on the ECG monitor screen. She then rushed to the rescue cart prepared by the nurse in the corner of the ward as quickly as possible, grabbed the sterile gloves on the upper layer, tore open the outer packaging, and put on the gloves skillfully.
"Do you want to perform chest compressions on her?" Dai Nanhui was frightened and shouted urgently, feeling that she might do such an operation while wearing gloves.
There was no time to answer this time. What was to be done might be a bit complicated and difficult to explain in a short time. Xie Wanying did not speak. In a blink of an eye, she returned to the bedside wearing gloves and gently lifted the film covering the incision to observe it with her eyes.
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