Chapter 341: [341] The teacher gave an opportunity Chapter 341: [341] The teacher gave an opportunity Xie Wanying’s hand, holding the suture scissors, snipped off the excess thread with a click.
The nurse across from the chief surgeon wiped the sweat from his forehead again.
In contrast, Xie Wanying’s face, although having been scolded most of the day, did not have a single drop of sweat rolling down, seemingly like a frozen object. The nurse and the anesthesiologist glanced at her face.
To say she wasn’t panicked was impossible. Teacher Sun had not notified her in advance to prepare mentally, and being suddenly called to be the first assistant did make her a bit nervous, Xie Wanying admitted. Even though she had witnessed Teacher Sun acting as the first assistant on many occasions and knew what tasks the first assistant should perform, it always takes time to adapt. Fortunately, her quick-thinking brain led her hands, and she had adapted.
In the second half of the surgery, the nurses and the anesthesiologist sighed with relief. The crack of Teacher Sun’s teaching whip in the operating room decreased, and the scolding ceased altogether.
Approaching the end of the surgery, Teacher Sun gave her the opportunity to practice another stitching method.
Due to the patient’s thin and frail body, clinical Teacher Sun decided to use a full-thickness decompression suture for the patient.
“Do you know how to stitch?” Teacher Sun asked.
Xie Wanying quickly responded, referencing her own patient case, “Teacher Tan stitched up bed 3 last time.”
That student often stole from his mentor’s experiences. Tan Kelin, with thin, cold, single eyelids, drooped his eyes slightly, and only the rotation of the teaching whip forceps in his palm could slightly reveal his amused yet indescribable emotions.
“Medical textbooks don’t usually go into much detail on this,” Sun Yubo recalled from his own textbooks of the past.
Textbooks that are compiled every few years cannot keep up with the rapid development of medicine. Knowledge from textbooks often becomes obsolete and impractical when it reaches clinical practice. This is why medical students are constantly urged to have ample intern time before graduating.
Medicine is a practical technical profession, and suturing is not about embroidering flowers on paper.
“Since you have seen Teacher Tan do it, give it a try,” Sun Yubo said without waiting for the student to answer, knowing this student memorized the textbooks well enough that there was no need to test her on that.
Xie Wanying could only nod, quickly reviewing the key points in her mind without pause.
Like the few times she practiced skin suturing which belongs to one layer of the layered sutures.
The surgery opened up several layers of the patient’s tissue, including skin, subcutaneous fascia, tendons, muscles, and peritoneum, to reach the organs. These tissues, once opened, needed to be sutured back together at the end of the surgery. Thus, the skin, fascia, tendons, and peritoneum were stitched layer by layer, which is known as layered suturing.
Full-thickness suturing, as opposed to layered suturing, means stitching several layers, such as skin and fascia, together at once.
For this malnourished patient, layered suturing might not promote wound healing and could even contradict the purpose of suturing, causing serous fluid to be unable to effectively drain or be absorbed, increasing the risk of infection. It is better to suture several layers together, as the suture pulls the tissues close to align them, and ultimately, healing depends on the patient’s own tissue growth and not on the sutures.
Decompression suturing works on the same principle. For emaciated patients who have less fat, sutures that pull the tissue too tight will result in unsightly, centipede-like hypertrophic scars. These patients often have high abdominal pressure and tissue tension internally, and a severe cough could easily burst the sutures. Therefore, to reduce the pressure on the incision, the points where the needle enters and exits are placed farther from the cut, a technique called decompression suturing.
Thus, the patient was not going to have the peritoneum stitched, just like bed 3.