Chapter 838 No one can fight
The surgeon who performed this operation was a senior professor in Shanghai, who was committed to improving the diagnosis and treatment level of obstetrics and gynecology. He had won the Shanghai Medical Outstanding Contribution Award and the National Outstanding Obstetrician and Gynecologist Special Award. He has published more than 150 SCI papers so far, and has made great contributions to the field of obstetrics and gynecology.
The advancement of laparoscopic surgery in obstetrics and gynecology in China was accomplished by Dr. Li Yahui.
However, at this moment, facing Xu Qiu, she still humbly stepped back a few steps and gave up the position of the surgeon.
No matter how impressive Li Yahui's qualifications are, it is difficult to compare with Xu Qiu.
What's more, Xu Qiu is also an academician...
"Academician Xu." Li Yahui's voice is very neutral, and the pronunciation is extremely clear. Just by listening to the voice, you can tell that this is a rigorous person.
In fact, it is true.
"Director Li."
Xu Qiu smiled in return, as a greeting.
Then, he stopped being polite and started suturing directly.
"Doctor Xu, can you tell us about it?" Li Yahui suddenly asked.
Jiade Medical Center has a reserve of famous doctors in various departments, but very few of them can make achievements in suturing.
Anyone who becomes the director will have good suturing skills, but they will never be very good.
Xu Qiu's suturing skills are hard to find rivals in the world, let alone Baiyun Province.
Therefore, Li Yahui and others are very envious... If they can learn some experience and skills from Xu Qiu, they will benefit a lot.
"Watch it." Xu Qiu chose to use suturing to give the answer.
He first carefully explored the area near the wound to find any foreign matter left in the wound.
For active bleeding, electrocution is used to stop bleeding.
And deplete inactive tissue.
At the same time, the edges of the wound need to be trimmed to facilitate subsequent anastomosis.
These steps can basically be omitted if Xu Qiu is the main surgeon.
He has made all preparations at the beginning of the abdominal incision, and there is no need for a second trimming.
However, this operation was performed by someone else, and he only finished the cesarean section.
"5-0 absorbable suture."
Xu Qiu used tissue forceps to fold the edge of the wound, observed the subdermal layer, and then inserted the suture needle into the subdermal layer.
After entering, Xu Qiu gently twisted the needle holder, and the subcutaneous and dermal layers were all within the range.
At the same time, Xu Qiu's voice sounded, saying: "Generally, when suturing a wound, just consider the apposition. This is also a detail that traditional suturing techniques pay attention to. It can make the wound look very flat, but after recovery, the scar will be very obvious, and the originally neat apposition line will most likely shift...
"The reason is the incision tension.
"As long as the subcutaneous dermis is eaten up and the wound forms a hill-like bulge, this problem can be solved... I also call it super tension reduction."
Super tension reduction?
This new technology made everyone stunned.
There are still many "tension reduction sutures" used in obstetrics and gynecology.
It is called tension reduction suture, but it is actually tension suture, and the most commonly used field is abdominal surgery.
The suture method is very simple, and it is considered one of the basic sutures for obstetricians and gynecologists.
Take the extraperitoneal tension suture as an example. First, close the peritoneum, then use a large curved triangular suture needle, and then use a solid No. 10 nylon thread to penetrate the abdominal wall fascia from the skin, with a needle every 3 to 4 cm, and the needle eye is 2 to 3 cm away from the incision edge. Without tying a knot, suture the fascia, subcutaneous fat and skin, and then put a 2 cm long rubber tube on the tension line, or clamp a small yarn ball, and finally tighten and tie the knots in turn...
In this way, the stitches can be removed in ten to fourteen days.
In normal surgery, after cutting the two sides of the wound, just close them and suture them. The tension will not be too great and it is not easy to break.
For abdominal wounds, too much skin is removed during surgery, and the defect is too large. If it is pulled up directly, the tension at the suture will be very high. The skin on both sides of the incision seems to be tug-of-war, and the risk of suture disconnection is very high.
In addition, abdominal distension is very common in abdominal surgery, which further increases the threat to the wound suture.
This is the role of adding a belly band after surgery.
Simply put, tension-reducing suture is to replace No. 4 thread with a thicker No. 7 thread, sew a few stitches, and play the role of "load-bearing column" to ensure that the wound will not collapse due to high tension.
However, the disadvantages are very obvious: the scar after the wound heals is very obvious. The greater the tension, the more "load-bearing columns" need to be left, and the scar of the wound is more conspicuous, and even a small earthworm may grow.
Xu Qiu's super tension-reducing method uses another method.
He inserts the needle from the superficial dermis on one side, sutures the fat tissue, and then withdraws the needle from the superficial dermis on the opposite side. When suturing, the position of the needle insertion and withdrawal is at the distance between the dermis and the subcutaneous fat layer. The needle is inserted from the dermis and then returns to the subcutaneous fat layer... All operations and needles are buried in the wound.
If you look closely, you can also find that Xu Qiu's sutures are controlled at the level of the papillary dermis, and the needle is withdrawn from the edge of the incision at the level of the reticular dermis...
Then comes the second suture.
Xu Qiu once again inserted the needle into the horizontal incision edge of the reticular dermis, then gently turned his fingers, tilted the needle holder upward and horizontally, and the apex of the suture needle also reached the level of the dermal papillary layer.
Quickly pass through the dermis, then enter the dermis and insert the needle upward and outward, and finally withdraw from the end of the incision!
Knot, cut off the stump...
With a click, the excess suture was cut off, and everyone just woke up from the dream.
"Finished...finished?" Li Yahui was fascinated by it, with an expression of disbelief on her face.
"It only took me a blink of an eye..." Another doctor also fell into self-doubt.
Is this the full-time buried mattress suture?
Such a delicate suture technique was actually presented in front of me, and the most terrible thing was that no one present could see it clearly!
Fast, too fast!
Everyone looked at the incision of the cesarean section again.
The incision edges were neatly aligned, and except for the point where the needle was inserted and removed, there was almost no suture line!
But this was just a performance, something that laymen could see.
What Li Yahui and others saw was the technology contained in Xu Qiu's suture technique!
He performed multi-level tension reduction in the shallow subcutaneous layer, and the way the suture needle went from the subcutaneous layer to the skin surface and then returned to the original position was bold and imaginative...
Just the latter, few people dared to challenge it.
If the needle is not carefully controlled, the skin will be more seriously damaged and scars will be left outside the wound.
And Xu Qiu did it!
And the control was extremely accurate!
"No, incredible..." Li Yahui's eyes bulged out and her face was full of astonishment.
Over the years, tension-reducing sutures have been improved.
In addition, a large number of clinically significant improved sutures have emerged, each with its own advantages and disadvantages.
However, there are very few sutures that are as superior as the "full-embedded mattress suture" provided by Xu Qiu.
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