Chapter 222 219. The Chaotic Operating Room

Surgery in the 19th century has made great progress compared to the previous wild stage. Most unreasonable operations are based on some wrong cognition, and the overall operation direction is still correct. For those doctors who are proficient in surgery, they only need to

With positive guidance, the technology will be greatly improved.

Perhaps in the eyes of outsiders, this kind of improvement is difficult to detect with observation, but the person who actually performs surgery has the deepest feeling.

This lifting can make the scalpel, needle and thread, hemostasis forceps, hooks, and tweezers in their hands feel like they are prolonging their arms.

Bill Rotte and Botini are typical representatives.

The former is 37 years old (there was a mistake in the previous period, he was born in 1829), and is in the preparation stage for the development of abdominal surgery. In more than 10 years, he will take out various abdominal surgery to improve the general surgery two to three levels.

The latter is 29 years old and has already had his own unique understanding and persistence in technology, and is on the road to rapid strengthening of surgical capabilities.

Even without Kawei, the two of them will follow their surgical path to their position in medical history. Now with Kawei, they can make them progress further than before with just a little help.

This kind of progress does not require much theoretical basis in the early stages, and the growth method is also leaps and turns to learn the work that should have been completed in half a lifetime.

Shotballs were not uncommon on the battlefield in the 19th century. They were the last line of defense of artillery soldiers, the most common weapon encountered by infantry and cavalry when striking artillery positions, and the direct cause of the death of many soldiers.

This type of firearm injury is not difficult for modern surgery.

There has long been a consensus on debridement, sterile technology, antibacterial treatment, hemostasis and blood volume supplementation required for treatment, and there are quite a few mature means.

At this time, the shotgun was simple to make and the explosives were much less powerful, which could not be compared with the fragment damage caused by the numerous cluster bombs on modern battlefields. But for Bill Rot and Botini who had not experienced the battlefield, the shotgun injury was

Their unknown territory.

For this reason, they found Kavi, and even went to the Royal Library to read the book left by the famous imperial artillery general Joseph Zamora - "Handbook of Austrian Royal Artillery Officers" [1], which describes the characteristics of the shotgun in detail.

The outermost layer of the shotgun is a cylindrical thin tin can, the bottom of the can is iron sheet, and there are hundreds of bullets with diameters between 1-5cm.

The moment the bullet body leaves the barrel, the tin shell will burst open, and the bullets will eject from it, forming a round cake-like barrage that spreads outwards in the space.

The texture and size of these bullets determine the strength and lethality of the barrage. Iron bombs have been used to replace lead bombs since the second half of the 18th century. Iron bombs are fast and can form a jumper after hitting the ground or obstacles.

Effectively increase the killing efficiency.

In Zamora's works, he compared the shotguns from Austria, Britain, France and other countries and found that the diameter of the shotguns was basically about one-tenth of their flight distance, and eventually formed a killing area similar to a quadrilateral.

If a team like the Krawolf Infantry Battalion encounters artillery attacks within an effective distance of 150 meters, almost every shotgun can cause varying degrees of damage to dozens of people.

"Fortunately, the light shotgun is not very large in diameter." Bill Rotter had already entered the abdominal cavity along the wound, and could clearly see the ballistic trajectory of the projectile entering the human body. "If the angle has not changed, the projectile should be near the liver.

.”

In fact, due to the injection angle, the projectile deflects after passing through the skin muscles, and then passes across the edge of the liver and continues to move diagonally upward.

Because of the poor penetration, the projectile eventually made a small hole in the diaphragm and almost entered the chest cavity.

But Bill Rotter's exploration was not that wide, and he would not care about the state of the diaphragm above the liver. What he had to do was to ensure that there was no problem with the injured abdominal cavity. Simply put, stop the bleeding if there was bleeding, and sew the crack if there was a crack.

Break.

If nothing

"This bullet is interesting, where did you go?"

Bill Rotter leaned against the chandelier with more than a dozen candles inserted on the top, but still couldn't find the projectile that entered the wounded soldier's body. Even though his hands wearing rubber gloves were trying to swap back and forth in his stomach, intestines, stomach, liver,

I passed my spleen all over again, but I still returned in vain.

Now, when I recall the scene when the injured soldier first entered the hospital, although his clothes were covered with blood, they were mostly caused by rupture of peritoneal blood vessels and there was no active bleeding.

Before, Bill Rotter was afraid that the bullet would cause the internal organs of the abdominal cavity to rupture and cause uncontrollable internal bleeding. However, after entering the abdominal cavity, he found that there was no semi-coagulation inside. After rinsing with saline twice, no new overflow was found.

blood.

So after searching for half an hour but failed, he decided to shut up: "Suck the water in his stomach, and then suture it after the intestines are returned to their place."

Botini, who was standing beside him, was still nervously sewing a large blood vessel on his thigh. Seeing that Bill Rotter was about to withdraw, he asked, "No projectile was found?"

"This guy is lucky. I have searched for a while but I haven't seen him." Bill Rotter looked at the wounded soldier's face, hoping to get more good luck from him, "I guess he's flying to other irrelevant places.

.”

"Is there no bleeding?"

"No."

"Well, just be alive, just keep the bullets."

Both of them strictly followed the firearm injury treatment principle advocated by Kawei [2], and simplified the operation as much as possible to reduce the damage to the surrounding normal tissue. In principle, the injury should not be aggravated if it has no significant impact on the human body.

, there is no need to take it.

"If you can still see his posture and injection angle when he was attacked, you might be able to directly judge the position of the projectile and don't even need to cut the belly."

Bill Rotter asked the injured again about the vital signs. After clarifying the stability of the numerical value, he decisively gave up continuing the operation: "Do you want help here?"

"No need, just slit the blood vessels." Botini touched the dorsal artery of the foot again, "The pulsation is pretty good, and the legs should be able to be kept."

Bill Rotter stepped forward and looked at it. After thinking that there was no problem, he gave the operating table to three assistants and ran to the entrance of the operating room alone to see if there was a next surgery. But in fact, he had just turned around.

Hills, who was also rushing for surgery behind him, sent him a bunch of wounded soldiers.

"The door was full of shotgun injuries, and fifty or sixty people had been sent, and a few of them were almost out of reach."

"I'll go and have a look."

Bill Rotter took off his disposable rubber gloves and apron and wanted to walk towards the door, but suddenly he was stopped by Hills: "No need, let's take a look at the one I'm on hand first, he is also seriously injured.

”

“What’s the situation?”

"As soon as the right thigh hit, the left thigh was directly blown off, and the left hand was cut open by shrapnel." Hills moved out of the angle and let Bill Rotter "appreciate" the left hand connected to his wrist with a layer of skin.

, and the exposed bones on the stump of the left leg, "but the heaviest thing is his neck."

This is no longer a question of whether the wounded is seriously injured. It is a miracle that the wounded soldier was sent here, and even still remains awake now.

"I know clearly that I've been knocked down!"

The wounded soldier covered the thick gauze covering the wound on the left side of his neck with the only intact right hand, and said in a very fast speed: "The abominable Prussian shell exploded directly at my feet. I was lying on the ground.

I felt like I was being run over my head by a carriage wheel, but at that time I didn't know that I was so seriously injured until I wanted to wipe the blood on my face with my left hand

When I discovered that "[3]

"Okay, we all know, let alone Major Cravor, your neck is starting to bleed out again!" Hills asked the anesthesiologist to cover his face with an ether mask, "Hurry and calm down Mr. Major.

.”

"Listen to me, you guys have never experienced what it feels like to lose a leg." Cravor had no intention of stopping at all, and continued, "That's a cannon shell, I knew when I saw it exploded.

I am going to be finished. God bless it, it must be God blessing. I am still alive now!"

Hills couldn't stand it anymore and helped cover the ether mask on his face: "Major, please be quiet, and now you are blessed by the Imperial Surgical Team!"

Cravor finally calmed down a little, and a trace of sadness appeared on his face after being overly calm: "Do you want to cut off my left hand?"

"Yes, it's impossible for the left hand to stay. The bandage of the stump of the left leg is too dirty and messy. We need to continue to cut off some of it upwards." Hills briefly introduced the operation process. After all, the other party was a major, "If you have good luck,

You should be able to see the moon tonight.”

"It's okay, come on!"

Cravor once again showed the calm that a commander should have, and even turned to look at the nurse holding ether aside, "It is the responsibility of every officer to offer his body to the empire. Complete your surgery quickly and wait for me to wake up.

I have to count the number of casualties and report it.”

Ether quickly passed through his lungs, and finally caused his brain to crash in half a minute.

Hills didn't know much about neck anatomy, or it could be said that he didn't have much experience. Cravorff's neck bleeding a lot and it was difficult to stop it, making people unable to help thinking that there was something wrong with the artery.

But as long as the wound is expanded and the anatomy is carefully found, you can find that the cut on his neck is caused by a fragment shot from the side that directly cuts his anterior jugular vein.

There are abundant blood vessels around this superficial vein, so it is almost impossible to stop bleeding in a short period of time with gauze bandages.

However, if hemostatic forceps and suture needles and threads are introduced, regardless of blood vessel integrity, the difficulty of the operation will decrease exponentially. Even in the end, even Hills is not necessary to stay on the stage.

It has to be said that the first two wounded soldiers Bill Rotter took over lack of "quality", which made him waste 40 minutes.

A large number of other wounded people waiting for surgical treatment at the entrance of the operating room did not need to be dispatched to the second shift. Because their injuries were on their limbs, either broke their hands or broke their feet. With current surgical methods, there was no need to leave behind.

The fortress hospital has a considerable reserve of surgeons. This 1,400-bed hospital is equipped with nearly 30 surgeons and more than 200 assistants, which is fully capable of dealing with the current amputation surgery.

The factors that limit their completion of treatment are just a sparse number of operating rooms.

But after hearing that there was still fighting ahead, Hills had vacated several temporary operating rooms, and the entire fortress hospital was in full force to digest the wounded people who were sent into the door.

Only after stabilizing the treatment capabilities of the fortress hospital, Bill Rotter had the opportunity to select wounded people who were suitable for his team.

Letting every medical staff appear where he should appear and avoiding waste of medical resources is an important part of the inspection system and it is also the original intention of Kawei to establish a trauma emergency team.

"The left forearm is missing, so you need to be amputated; the right calf is broken, and the abdominal cavity is amputated, and the face is not very good." Bill Rotter checked the wounded at the door and made his own judgment simply, "Hills, there is a

If you want to investigate, there may be internal bleeding, so you can do it."

"Okay, I'll send it to the operating room now."

"The next thing is a serious open fracture of the right leg, amputation; a shot in the chest. It seems to be a sternum fracture?" Bill Rotter had a brief examination and finally became interested. "Botini, there is a person who was shot in the chest here."
To be continued...