For the longest time, I couldn't remember what knowledge point she was talking about. Fortunately, he was also an honors student, so he was smart enough to follow classmate Xie and ask, "What do you mean by that?"
As he asked, his face turned a little red with embarrassment. He must have remembered the time when he had laughed at Geng Lingfei, saying that he was an idiot for following classmate Xie, but now he was an idiot.
"The breasts were not closed at the end of the operation." Xie Wanying is a modest person and will not pretend to be aloof and ignore her classmates. She will answer within the time limit.
At this moment, Dai Nanhui was suddenly moved.
The two ran to the ward next door.
Xiao Hui, lying on the snow-white sheets, has a snow-white face. The tracheal tube in her throat is connected to a ventilator, and other machine tubes are connected to other parts of her body. She is like a broken doll relying only on machines to support her life. Look at her.
It's heartbreaking.
Xie Wanying's hand carefully lifted the child's quilt, revealing the child's chest.
Seeing the transparent dressing on the child's chest, Dai Nanhui finally remembered the relevant knowledge: "It doesn't matter if it's the sternum."
Delayed chest closure, as Xie said, the surgeon did not follow the routine surgical procedure to close the patient's chest at the end of the operation. The most important step in closing the chest is to close the sternum.
Why don't doctors close the sternum?
Most of the time, doctors don't close it because they find that the chest cannot be closed after surgery.
What’s so weird? Can’t the sternum be pulled up? Can it be pulled up during deadlifts?
To be precise, once the chest cavity is closed, the patient's life will be lost, so it cannot be closed. This situation is specifically reflected in the fact that after closing the sternum, it may compress the heart and cause a cardiac crisis. It may cause bleeding from the large blood vessels of the heart and require open chest gauze packing.
How can I close it by applying pressure to stop bleeding? Maybe it can't be closed if I need to open the chest and open drainage for cardiac tamponade.
What are the benefits of not closing the median sternotomy and keeping the sternum open? It can expand the volume of the patient's mediastinum, reduce the compression on the heart, mainly the external pressure on the ventricular wall, and increase the end-diastolic volume of the heart, all of which are conducive to stabilizing the patient.
blood circulation and breathing.
Delaying chest closure does not mean that the patient's sternum is really not closed. It just means that the patient's sternum will be closed after the patient's critical situation has passed.
What to do 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 such patients may need rescue at any time, many doctors now choose to only cover the wound with a layer of sterilized transparent surgery
Film protection.
If you look closely, through the transparent film, you can see that the unclosed sternum is being held open by a sternum expander.
What should we do in this situation? Do intra-chest cardiac compression 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 locked on the ECG data on the ECG monitor screen, and then she rushed as quickly as possible to the emergency vehicle prepared by the nurse in the corner of the ward, grabbed the sterile gloves on the upper floor, tore open the outer packaging, and put on the gloves skillfully.
.
"Do you want to perform intrachest heart compression on her?" Dai Nanhui felt that she might have to perform such an operation while wearing gloves. Dai Nanhui was frightened and shouted urgently.
There was no time to answer this time. What had to be done might be a bit complicated and difficult to explain clearly in a short time. Xie Wanying didn't say anything. In the blink of an eye, she returned to the bedside with gloves on, gently peeled off the film covering the incision and looked at it with her eyes.
