In order to allow Tang Tian and Lin Sheng to see clearly, Tang Lou deliberately worked slowly and explained the tips and key points while doing it.

Tian Linsheng felt a little confused when he heard it. Without personal experience, he naturally couldn't understand it immediately. Qing Ping on the side felt like he was competing with his peers to confirm his experience.

"Beautiful~"

Qingping sighed sincerely, and Tanglou quickly began to clean up the pus from the pelvic floor and right paracolic groove.

After checking that there was no bleeding and counting the instruments, Tang Lou stood aside.

"Tian Linsheng, it's up to you to close the belly next."

Tian Linsheng felt as if he was hearing the sound of a fairy, his whole body trembled with excitement, and another wave of nervousness came over him, and he walked cautiously to the operating table.

He glanced at Tang Lou nervously: "Doctor Tang, I'm starting."

There was a bit of trembling in his words. Seeing Tian Linsheng's reaction, Qingping also smiled knowingly. This is the reaction of a normal person.

Compared to Tanglou, it is a monster!

Qingping still remembers that after the first abdominal closure and suturing, he had to sleep for several days to ensure that the abdominal closure was tight. He was afraid that the patient would turn over after the operation and his intestines would leak out...

"...Holding needle pliers, needle and thread..."

Tian Linsheng recalled Ma En's previous operations. After all, Tanglou's movements were too fluent and fast and were not suitable for him.

Holding the needle pliers, Tian Linsheng was already in a cold sweat, and his hands were still shaking a little. Yesterday, he practiced with pork, but he was still a little panicked.

Especially since this patient was obese and had a relatively thick fat layer, when Tian Linsheng was suturing the anterior sheath of the rectus abdominis, he suddenly found that he could not identify the anterior sheath and subcutaneous fat tissue.

"I..."

Tian Linsheng was about to cry, but thinking that this was his first suture, he swallowed his saliva and gritted his teeth. The movements he had practiced several times in his mind became a little stiff...

The stitch length and margin taught in Tanglou yesterday had been forgotten for a long time. The most terrifying thing was that Tian Linsheng clearly felt that he was slightly lifted, but his peritoneum was directly torn.

"!!!"

If there were mobile phones now, Tian Linsheng would like to post on WeChat Moments: "What should I do if the patient's peritoneum is torn by sutures during the operation? Wait online? It's quite urgent!!!"

At this time, Qingping couldn't help it anymore: "Tian Linsheng, how is your anatomy study?"

When Tian Linsheng heard Qingping's voice, his body trembled, his face turned red and he felt guilty: "Just so so."

Qingping: "Then do you know where the carotid artery is?"

Tian Linsheng: "Huh?"

Qingping: "Change the needle pliers into a scalpel and scratch it."

Tian Linsheng's soul had already left his body: "???"

Qing Ping: "With your kind of suturing, the patient won't get better anyway, so I'll just give him a break."

Tian Linsheng: "..."

Chen Wenhao covered his mouth and was very happy: "It's begun, it's begun! Doctor Qing is attacking people online!"

As soon as Qingping finished speaking, Tanglou had a dark face and refused to be outdone:

"Tian Linsheng, I gave you extra lessons yesterday for nothing. I think you should not learn suturing in the future. Instead, you should work hard to repair large-area defects in maxillofacial tissue first. It would be more suitable for you!"

Tian Linsheng wanted to say in his heart: "Boss, please speak your mind!"

Of course he knew that what Tang Lou said was definitely not a good thing, but when the surgeon in charge was giving him a lecture, even if he knew there was a critical attack behind him, he still had to pretend to be obedient and cooperative.

Tian Linsheng showed his eight teeth professionally and smiled slightly: "I will study hard."

Tanglou: "Well, after you learn it, do it for me. If you teach a student like you, I have no choice but to let go of my extremely handsome face."

Qingping: "...."

Chen Wenhao: "...."

Sure enough, the surgeon started to curse, each one more harsh than the other.

After the two jokes, Tian Linsheng's stiff limbs relaxed a little, but his heart hurt a little, and he still wanted to have a knife on his artery and perform a cheek operation on himself.

This way, no one will know who the rookie was who died because he couldn't do it well.

Tanglou saw that Tian Linsheng had resumed his thinking, and then he said seriously:

"Although the patient's fat layer is relatively thick, there is no need for suturing. Suturing will only make it difficult for the fluid to escape from the foreign body. The skin should not be sutured too tightly. Just tie the knotted skin close to the top. Don't tie it too tightly. Too tight will affect the blood flow.

It is very important to remove the necrotic fat under the skin, wash the incision and stop the subcutaneous bleeding accurately.”

"ah!"

Only then did Tian Linsheng realize that one of his stitches was too tight, and the other one was that the damn sutures were just adipose tissue, not the peritoneum!

Let me tell you! It tore apart.

Tian Linsheng, you must be stupid to death for yourself

?°(°ˉ??ˉ?°)°?

"What did I tell you yesterday? The techniques for abdominal suturing are: wide, loose, full-thickness, wide stitches, and appropriate margins. Under anesthesia, tighten the sutures forcefully. When the patient wakes up from anesthesia, the patient's abdomen will bulge. You can imagine it yourself.

It looks like cutting tofu with a thread."

Tanglou continued to complain about Tian Linsheng.

Tian Linsheng's face was already so hot that he could fry an egg, but he really admired him in his heart. He was also an intern, and Tanglou's understanding of abdominal confinement was so profound.

Qingping on the side also nodded frequently. Tanglou's explanation was more detailed than him, it was almost textbook level.

"No wonder this guy acted like a veteran during his first surgery. His theoretical knowledge is really solid!"

The more you perform surgery with Tang Lou, the more you can understand his power.

Chen Wenhao on the side also looked a little solemn, there was something special about Tanglou.

Tanglou's tone has become serious:

Tian Linsheng, this patient has a thick fat layer, so we need to pay special attention to it. If the subcutaneous fat suturing problem is not handled well, then you will be prepared to face the patient with a stern face every day.

Intermittent suturing of subcutaneous fat leaves too many knots and foreign bodies, which is the root cause of fat liquefaction and thread reaction at the surgical site.

Some surgical incisions react with threads, exuding repeatedly until the last knot is taken out. Moreover, the subcutaneous fat is sutured intermittently. Once infection or liquefaction occurs, it will be difficult to expand and drain the subcutaneous sutures unless the sutures are removed and the surgical incision is opened.

Tian Linsheng was suddenly startled, so he cleverly prepared to use more powerful mattress sutures. Just as he was about to start, Tanglou immediately stopped:

Suturing the skin with silk thread mattress is even more unnecessary. Skin mattress suturing is difficult to loosely fit the skin, and the knot is often required to be too tight. This will cause tissue ischemia and is not conducive to drainage. Unless the elderly patients have loose skin, it is not suitable

Silk thread mattress suturing of the skin is recommended.

Tian Linsheng: "!!!"

It's so difficult for me, I really want to go back and continue my hooking.

After Tanglou pointed out Tian Linsheng's mistake, he began to explain the abdominal closure method he designed for this obese patient:

"Yesterday, after studying the patient's body shape and medical history, I formulated the following suture plan."

Hearing Tanglou's words, Qingping's eyes lit up. No wonder this guy didn't rush every time he had an operation. He had done enough homework in advance, and even made a special plan for abdominal surgery.

Tian Linsheng was also hit hard in his heart, and then he was extremely admired. It was reasonable for him to do well.

What were you doing yesterday?

Although I was fantasizing and thinking about how my first abdominal intubation would go, if I had carefully studied the medical records yesterday, considered the abdominal intubation plan in advance, and even consulted Tanglou in advance, I am afraid that I would not be in this dilemma today.

Tian Linsheng, at this moment, he really regarded Tanglou as a teacher.

Falling to the ground!

Chen Wenhao was also in awe. Tanglou's rigorous attitude was really hard not to admire.

The pretty nurse has gleaming eyes and is so handsome. She still has such a good life.

When several people were shocked, Tang Lou calmly began to explain the abdominal closure plan he designed for the patient:

The first layer: The margin of the long continuous suture of double-strand parallel PDS suture is about 1cm. The midline surgical opening includes the peritoneum and the linea alba. Do not get the peritoneum stuck on the linea alba; the rectus abdominis muscle opening includes the peritoneum and posterior sheath.

Afraid that Tian Linsheng wouldn't understand, Tanglou explained the PDS line again:

Since there are many styles of PDS threads, the double-stranded parallel PDS thread with two zeros is equivalent to the traditional No. 7 thread. The domestically produced one is the so-called Pudis, and the label is also PDS. This thread is also often used to suture tendons.
Chapter completed!