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Chapter 56 Skin Grafting
Chapter 56 Skin Grafting
Different from ordinary hanging bottle drops, the catheter placed in the deep jugular vein catheterization is directly connected to the patient's superior vena cava.During infusion, the fluid passes directly through the superior vena cava into the right atrium.Relying on the push of the heart, the supplemented fluid can be quickly distributed to various parts of the body.It is very beneficial to both large-volume infusion and rapid rehydration - it directly enters the heart, and releases the drug to the whole body through the heart, avoiding the stimulation of blood vessels by high-concentration drugs as much as possible.As for the possibility of rapid infusion leading to left heart failure...Replenishing blood volume as soon as possible now is definitely relieving the pressure on Zhao Weihong's heart, not adding additional load.
Zebra glasses doctor quickly completed the dispensing of fentanyl, and the micropump was connected to the previously placed infusion tube.
"One milliliter of infusion per hour is actually too much for a 67-year-old." Dr. Zebra pushed his glasses, and the sense of accomplishment of completing the work quickly gave him the desire to chat with others.When he was in the operating room in the morning, Dr. Zebra knew that Sun Lien was a regular trainee, and he also intended to pass on some corresponding knowledge to Sun Lien, "According to general experience, patients over 60 years old should reduce their medication by half at the beginning, otherwise the overdose of opioids will suppress them." Pain medications can cause depression of the respiratory center. But with advanced airways and ventilators, this danger is not really a problem."
After Dr. Zebra connected the analgesic pump and the catheter, the nurse next to him immediately connected the prepared balance solution to the main inlet of the catheter.The regulator that adjusts the input is directly opened to the maximum without looking at it, allowing the balance fluid to flow into Zhao Weihong's neck vein along the pipe.In less than 10 minutes, half of the 500ml bottle of balance liquid went down.
If it were an ordinary person, they would definitely start sweating after such a ruthless rehydration.But Zhao Weihong not only did not show any discomfort, his heartbeat even dropped slightly.
"Continue to rehydrate and call the family members. The burn may require early skin grafting, and the family members must sign a consent form." Sun Lien was slightly relieved, and Zhao Weihong's response to the rehydration and analgesia was not bad.Although old age is a decisive unfavorable factor for recovery, fortunately, the area of the burn wound is not particularly large-the entire back accounts for about 13% of the total body area, and a third-degree burn of such an area is actually considered unfortunate. Fortunately.
But the danger of back burns is equally great. Unlike the front chest and abdomen, the thickness of the tissue on the back is actually quite limited.The fat layer under the skin, which can play a certain role in heat insulation, is not as thick as the chest and abdomen.Moreover, the back is actually closer to the vital organs of the body, so back burns can sometimes cause more serious damage than it looks.
Zhao Weihong's family currently has only one daughter who pays the fee outside.Sun Li'en, who has dealt with her before, probably also understands that this family is in some trouble.He lowered his voice and asked Liu Tangchun, "Mr. Liu, can you come with another family member?"
"What? Do you want to change another patient?" Liu Tangchun was also a little helpless, "If the patient is only this child, will you treat it or not?"
Sun Lien sighed, "Even if it is out of humanitarian considerations, putting her jugular vein catheter has reached the bottom line. If there is no permission to do skin grafting, the family will definitely have to make trouble."
"Let's make trouble." Liu Tangchun gritted his teeth, and then his anger turned into a long sigh of helplessness, "What else can I do? I'll go talk to the family members, I hope this fire can clear her mind. some."
The doctors in the burn department had already started preparations nearby. The 13% area of skin grafting had exceeded the limit of autologous skin grafting. It was completely impossible to rely on the patient's own body for skin grafting.The only option at present is to use a special material for artificial skin grafting - decellularized pigskin.
Most doctors like pigs, especially burns and surgery.The burn department needs to use pigskin to protect patients with extensive burns.Surgery is more straightforward. The pig's heart, liver, spleen, lungs and kidneys are good teaching materials for practicing.For the liver and gallbladder, it goes a step further. In the artificial liver support system developed by Academician Li Lanjuan, the main biological material that works—the hollow fiber tube of pig liver cells also comes from pigs.
Decellularized pig skin needs to be stored frozen and then taken out for rewarming just before use.And this time just happened to be used to communicate with the patient's family.
Under the strong suggestion of Liu Tangchun and the police, the middle-aged woman called her husband.The man appeared to be in his early fifties, wearing a pair of silver glasses, a black jacket, a white shirt, and no tie.
"What's going on?" His attitude was much better than his wife's. After nodding towards the doctor, he pulled the middle-aged woman aside and asked in a low voice, "Didn't you say take mom to Have you eaten yet? Why did it burn like this?"
The middle-aged woman seemed to have finally seen her savior, wiped her tears and told the story, "My mother choked while eating, and there was a young man and his girlfriend to help..."
The two couples here were talking about what happened. Director Zang Fusheng of the hospital just finished working overtime and passed the rescue hall.Seeing that there was a big battle here, I stood by the side curiously and took a second look.
His eyebrows furrowed deeper and deeper, and after a while, he suddenly pulled Liu Tangchun's clothes, and said in a low voice, "Old Liu, this man seems to be the District Chief Ouyang Hua of our district."
After listening to the first half of the story, Ouyang Hua nodded in fear and said, "Under the current social environment, it is not easy for young people to stand up and act bravely. Have you thanked him?"
The middle-aged woman said without changing her expression, "Of course I'm thankful, but he's so upright that he didn't leave any contact information at all."
"What happened later?" Ouyang Hua continued to ask, "How did our mother burn like this?"
"The old lady didn't want to stay in the hospital after waking up. I discharged her from the hospital." The middle-aged woman continued, "When she was about to get home, Mom said that her shoulders were uncomfortable recently, and her old rhinitis also had a headache. I was a little dizzy. I always heard people say that the health fire treatment next to our house has a particularly good effect, so I took my mother to do it. The doctor said that a small needle knife can also be used to treat rhinitis, as long as pus is released Can be good..."
Sun Lien, who was about to go out to ask for permission, happened to hear the part of the small needle knife, he stared round his eyes and interjected directly, "The patient had a small needle knife? What part is it?"
The middle-aged woman who was interrupted was a little unhappy, but after all, she was guilty of lying just now, and she didn't dare to be too arrogant and domineering in front of her husband, so she could only curl her lips and honestly replied, "It's from the nose. .”
"How long is that little needle knife?" Sun Lien asked, "How wide is it?"
"About this long?" The middle-aged woman drew an outline about fifteen centimeters long. "The width...is half the width of a finger. After piercing it to the end, my mother said that the nose felt very comfortable."
Thanks to brother Fusheng for the permission of the dragon set~
(End of this chapter)
Different from ordinary hanging bottle drops, the catheter placed in the deep jugular vein catheterization is directly connected to the patient's superior vena cava.During infusion, the fluid passes directly through the superior vena cava into the right atrium.Relying on the push of the heart, the supplemented fluid can be quickly distributed to various parts of the body.It is very beneficial to both large-volume infusion and rapid rehydration - it directly enters the heart, and releases the drug to the whole body through the heart, avoiding the stimulation of blood vessels by high-concentration drugs as much as possible.As for the possibility of rapid infusion leading to left heart failure...Replenishing blood volume as soon as possible now is definitely relieving the pressure on Zhao Weihong's heart, not adding additional load.
Zebra glasses doctor quickly completed the dispensing of fentanyl, and the micropump was connected to the previously placed infusion tube.
"One milliliter of infusion per hour is actually too much for a 67-year-old." Dr. Zebra pushed his glasses, and the sense of accomplishment of completing the work quickly gave him the desire to chat with others.When he was in the operating room in the morning, Dr. Zebra knew that Sun Lien was a regular trainee, and he also intended to pass on some corresponding knowledge to Sun Lien, "According to general experience, patients over 60 years old should reduce their medication by half at the beginning, otherwise the overdose of opioids will suppress them." Pain medications can cause depression of the respiratory center. But with advanced airways and ventilators, this danger is not really a problem."
After Dr. Zebra connected the analgesic pump and the catheter, the nurse next to him immediately connected the prepared balance solution to the main inlet of the catheter.The regulator that adjusts the input is directly opened to the maximum without looking at it, allowing the balance fluid to flow into Zhao Weihong's neck vein along the pipe.In less than 10 minutes, half of the 500ml bottle of balance liquid went down.
If it were an ordinary person, they would definitely start sweating after such a ruthless rehydration.But Zhao Weihong not only did not show any discomfort, his heartbeat even dropped slightly.
"Continue to rehydrate and call the family members. The burn may require early skin grafting, and the family members must sign a consent form." Sun Lien was slightly relieved, and Zhao Weihong's response to the rehydration and analgesia was not bad.Although old age is a decisive unfavorable factor for recovery, fortunately, the area of the burn wound is not particularly large-the entire back accounts for about 13% of the total body area, and a third-degree burn of such an area is actually considered unfortunate. Fortunately.
But the danger of back burns is equally great. Unlike the front chest and abdomen, the thickness of the tissue on the back is actually quite limited.The fat layer under the skin, which can play a certain role in heat insulation, is not as thick as the chest and abdomen.Moreover, the back is actually closer to the vital organs of the body, so back burns can sometimes cause more serious damage than it looks.
Zhao Weihong's family currently has only one daughter who pays the fee outside.Sun Li'en, who has dealt with her before, probably also understands that this family is in some trouble.He lowered his voice and asked Liu Tangchun, "Mr. Liu, can you come with another family member?"
"What? Do you want to change another patient?" Liu Tangchun was also a little helpless, "If the patient is only this child, will you treat it or not?"
Sun Lien sighed, "Even if it is out of humanitarian considerations, putting her jugular vein catheter has reached the bottom line. If there is no permission to do skin grafting, the family will definitely have to make trouble."
"Let's make trouble." Liu Tangchun gritted his teeth, and then his anger turned into a long sigh of helplessness, "What else can I do? I'll go talk to the family members, I hope this fire can clear her mind. some."
The doctors in the burn department had already started preparations nearby. The 13% area of skin grafting had exceeded the limit of autologous skin grafting. It was completely impossible to rely on the patient's own body for skin grafting.The only option at present is to use a special material for artificial skin grafting - decellularized pigskin.
Most doctors like pigs, especially burns and surgery.The burn department needs to use pigskin to protect patients with extensive burns.Surgery is more straightforward. The pig's heart, liver, spleen, lungs and kidneys are good teaching materials for practicing.For the liver and gallbladder, it goes a step further. In the artificial liver support system developed by Academician Li Lanjuan, the main biological material that works—the hollow fiber tube of pig liver cells also comes from pigs.
Decellularized pig skin needs to be stored frozen and then taken out for rewarming just before use.And this time just happened to be used to communicate with the patient's family.
Under the strong suggestion of Liu Tangchun and the police, the middle-aged woman called her husband.The man appeared to be in his early fifties, wearing a pair of silver glasses, a black jacket, a white shirt, and no tie.
"What's going on?" His attitude was much better than his wife's. After nodding towards the doctor, he pulled the middle-aged woman aside and asked in a low voice, "Didn't you say take mom to Have you eaten yet? Why did it burn like this?"
The middle-aged woman seemed to have finally seen her savior, wiped her tears and told the story, "My mother choked while eating, and there was a young man and his girlfriend to help..."
The two couples here were talking about what happened. Director Zang Fusheng of the hospital just finished working overtime and passed the rescue hall.Seeing that there was a big battle here, I stood by the side curiously and took a second look.
His eyebrows furrowed deeper and deeper, and after a while, he suddenly pulled Liu Tangchun's clothes, and said in a low voice, "Old Liu, this man seems to be the District Chief Ouyang Hua of our district."
After listening to the first half of the story, Ouyang Hua nodded in fear and said, "Under the current social environment, it is not easy for young people to stand up and act bravely. Have you thanked him?"
The middle-aged woman said without changing her expression, "Of course I'm thankful, but he's so upright that he didn't leave any contact information at all."
"What happened later?" Ouyang Hua continued to ask, "How did our mother burn like this?"
"The old lady didn't want to stay in the hospital after waking up. I discharged her from the hospital." The middle-aged woman continued, "When she was about to get home, Mom said that her shoulders were uncomfortable recently, and her old rhinitis also had a headache. I was a little dizzy. I always heard people say that the health fire treatment next to our house has a particularly good effect, so I took my mother to do it. The doctor said that a small needle knife can also be used to treat rhinitis, as long as pus is released Can be good..."
Sun Lien, who was about to go out to ask for permission, happened to hear the part of the small needle knife, he stared round his eyes and interjected directly, "The patient had a small needle knife? What part is it?"
The middle-aged woman who was interrupted was a little unhappy, but after all, she was guilty of lying just now, and she didn't dare to be too arrogant and domineering in front of her husband, so she could only curl her lips and honestly replied, "It's from the nose. .”
"How long is that little needle knife?" Sun Lien asked, "How wide is it?"
"About this long?" The middle-aged woman drew an outline about fifteen centimeters long. "The width...is half the width of a finger. After piercing it to the end, my mother said that the nose felt very comfortable."
Thanks to brother Fusheng for the permission of the dragon set~
(End of this chapter)
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