Practicing Medical Skills in a Small Clinic-Chapter 245 - 148: Jaw Abscess, Men’s Hardships (Part 3)

Chapter 245: Chapter 148: Jaw Abscess, Men’s Hardships (Part 3)

If the facial incision is necessary to drain the pus, post-operative suture scar issues must definitely be considered.

Especially for women who love beauty, extra caution is required.

After the ultrasound examination, Li Jingsheng found the lesion’s boundaries unclear, with uniform internal echo and a lesion area greater than 5*7.

An abscess has three stages.

The pre-abscess stage, abscess formation stage, and abscess absorption stage.

Currently, it’s between the pre-abscess and formation stages.

If left untreated, the lesion area will continue to expand, eventually leading to oral or facial rupture with pus discharge. Such a large abscess range already poses a serious risk of poisoning.

And the possibility of septicemia.

After the ultrasound, Li Jingsheng used an infrared ear thermometer to check her temperature, which showed a low-grade fever.

37.4 degrees.

Measured again, 37.5 degrees.

Temperature fluctuations during measurement are very normal.

The patient developed a low-grade fever.

Temperature rise also indicates the immune system’s response, initiating a full-scale attack on this abscess lesion.

Ordinary small abscesses, such as common pimples, won’t cause a temperature rise.

The patient’s temperature increased by nearly a degree, which is the immune system’s initial response. If septicemia occurs, the immune system won’t handle it, leading to high fevers and chills.

"Is my situation not serious?"

The patient asked.

"It’s considered quite serious, with an internal abscess of considerable area. You’re not experiencing symptoms like chills, are you?"

"No."

The patient denied.

"I just gave you a thorough examination; injections alone won’t solve your situation. I suggest incision and drainage might be necessary, possibly requiring larger surgery to separate the pus-affected tissues. Followed by injections for anti-inflammation and infection control, the condition should be controlled in three to four days."

Li Jingsheng really hopes to secure this case.

Not just for the money, but to gain experience in this diagnosis and treatment area, while enhancing surgical skills. The earned value of life shouldn’t be too small.

The advantages are many, so he is naturally proactive.

"Surgery? Can you do it here?"

Upon hearing the need for surgery, the patient hesitated. The small clinic’s level is difficult to trust as very high.

"We can do it."

Li Jingsheng answered firmly.

"Our boss has excellent surgical skills! Look, this young man had a large cut on his waist, so long. After our boss treated him, he is now almost fully recovered."

Tang Ping pointed at the young man who came for a follow-up, boosting Li Jingsheng’s reputation.

The young man smiled bashfully.

"Well... I’ll call my husband first. How much would the surgery cost?"

"The total estimated cost is around eight hundred, if the drainage effect isn’t great, expanding the surgery might reach around two thousand." Li Jingsheng could only give an approximate cost estimate.

In larger hospitals, a simple skin flap suture costs over seven hundred, purely for surgery.

This patient’s surgery difficulty is certainly not small, the risk is quite high, and treatment will require three to five days of intravenous injections. Eight hundred is really not much.

Li Jingsheng knows the small clinic’s only advantage is no queues, low cost, and convenience.

It’s just starting out; don’t think about earning much immediately. First, securing the business offers a chance to expand the reputation.

Many people practically don’t know he can perform surgeries here.

The woman went aside to call.

Li Jingsheng checked the waist wound on the young man, healing at the best Master Level.

No inflammation, no infection, no rupture, no pus discharge.

The wound has essentially preliminarily healed.

"After two days, you should come over to have the stitches removed, no need to come tomorrow."

Li Jingsheng prescribed erythromycin ointment for him to apply at home.

Such a long wound healing so quickly has given Li Jingsheng greater confidence.

If returning to work at the First Hospital now, skin suturing tasks can be completed no worse than attending physicians.

As for excellent interns and resident physicians, their suturing skills certainly don’t match his.

Just then, a new patient arrived.

"Doctor, I’ve brought my wife over for you to see."

The man who asked about bone setting this morning brought a frail woman over.

This woman was particularly slender, with dull yellow hair and slow walking.

Her actions were less agile than some elderly individuals.

"Injured right wrist, mm?"

Li Jingsheng signaled the woman to sit.

"Yes."

She carefully rolled up her right sleeve, the wrist looking extremely fragile, like a delicate young lady from ancient times. Truly weak as if unable to wield a knife.

The skin was rather dusky.

Visually examined, no obvious redness or swelling, only some abrasions under the wrist and on the palm.

Falls happen to everyone.

Not to mention children, being mischievous and active, attempting dangerous actions. Falling is practically routine.

Adults are generally more steady, rarely falling.

But unfortunately, after falling, their injuries are often much more severe than children’s.

This woman is too skinny, severely lacking protective fat layers, so when falling, it’s basically just bone taking the hit.

"This hand can’t exert force, especially when lifting basins or holding bowls, it’s very painful."

She voluntarily described her symptoms to Li Jingsheng.

"Let me check it for you."

Li Jingsheng used the Minor Achievement level Bone Touching Skill to palpate her bones.

Maintaining a serious expression all along.

Her husband was standing right beside; groping her hand could lead to misunderstandings.

This isn’t too bad. Male doctors in the hospital’s Breast and Thyroid Surgery department face real danger when doing palpations for female patients with breast lesions.

His movements were gentle yet precise, and especially steady.

Compared to Master Level Bone Touching Skill, there’s obviously much improvement.

Already able to achieve steadiness, accuracy, and gentleness. Mastered the techniques like two light and one heavy touch, three fixed points during bone palpation.

His judgment on bone structure also improved significantly.

Previously, he could only judge bone density; now he has a clearer tactile judgment of bone flexibility, density, and possibility of lesions.

Even some sense of bone vitality can be felt.

After palpating, he felt assured.

It’s not a serious problem, just minor dislocation of the wrist bone, with a slight fracture found.

"Can it be treated?"

"The issue isn’t very large, there seems to be a fracture, so an X-ray is needed."

Li Jingsheng definitely needs to take an X-ray before treatment.

If anything happens, having the X-ray serves as the best evidence.

"Oh, the bone is broken! No wonder it hurts that much! Please go ahead with the X-ray!"

Upon hearing of the fracture, the woman showed a clearly fearful expression.

"Fractures have multiple levels, your bone hasn’t completely broken. Like a small stick, if bent forcefully, cracks appear but don’t break — that’s roughly the idea."

Li Jingsheng explained.

"How much for the examination?"

The woman’s husband cared more about the cost.

"One hundred yuan."

"Can it be avoided?"

"Certainly not! This is the most basic examination. In larger hospitals, they might require a CT scan, which is much more expensive."

Li Jingsheng discovered making money at a small clinic is genuinely challenging.

Doing a hundred-yuan examination, and the patient wants to haggle it down.

That’s unheard of in large hospitals; routine checks are directly ordered by doctors without consulting the patient.